W2 Case 1

Case 1: Primary Herpetic Gingivostomatitis

Patient History¹

• 20-month-old boy
• Fit and well
• Fever for 3 days
• Poor oral intake (accepting only ice cream)

Clinical Considerations

• Questions for parents?
• Diagnosis?
• Causative agent?
• Infectiousness?
• Peak incidence?
• Management

Clinical Presentation and Diagnosis

Etiology and Epidemiology²

• Causative Agent: Herpes simplex Virus Type I
• Peak Incidence: 12-18 months

Systemic Symptoms

• Fever
• Headaches
• Malaise
• Irritability
• Cervical lymphadenopathy

Oral Manifestations

• Oral pain and mild dysphagia
• Stomatitis
• Appearance of intraepithelial fluid-filled vesicles
• Painful, enlarged gingiva
• Erosions of the free gingival margin

Transmission and Disease Course

Disease Progression³

• Incubation Time: 3-5 days
• Initial Presentation: 48-hour history of irritability, pyrexia, and malaise
• Course of Disease: Self-limiting; typically heals within 10-14 days

Transmission

• Direct contact with active lesions
• Contact with infected oral secretions

Management and Analgesia

Symptomatic Care⁴

• Maintain intake of oral fluids
• Bed rest
• Soft diet (e.g., ice cream)

Pharmacological Management

• Analgesia calculation based on patient weight (12kg)

Dosage Calculation for 12kg Patient⁵

Paracetamol Dosage:

• Standard Dose: 15mg/kg every 4-6 hours
• Maximum Limits: 1g per dose, 4g per day
• Calculation: 15mg x 12kg = 180mg every 4-6 hours

Administration (Panadol 1-5yrs Suspension):

• Concentration: 24mg/ml
• Volume Calculation: 180mg / 24mg/ml = 7.5ml every 4-6 hours

Footnotes

1. Original PDF page 2: W2 Case Based Discussion 2, p.2 ↩

2. Original PDF page 3: W2 Case Based Discussion 2, p.3 ↩

3. Original PDF page 4: W2 Case Based Discussion 2, p.4 ↩

4. Original PDF page 5: W2 Case Based Discussion 2, p.5 ↩

5. Original PDF page 6: W2 Case Based Discussion 2, p.6 ↩