Herpes Viruses
“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 984
“The human herpes viruses may promote a disease state in three distinctive ways: (1) direct destruction of cells and tissues, (2) induction of immune responses, and (3) facilitation of neoplastic transformation.” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 984) (pdf)
Herpes Simplex
HSV 1
“l, infected patients (Arduino and Porter 2008). Primary HSV-1 infection typically affects the mouth and arises within 1–2 weeks of acquisition of the virus. The clinical features comprise initial nonspecific features of malaise, pyrexia, and lethargy followed by the eruption of widespread ulceration of the oral mucosa and gingiva (Cunningham et al. 2006).” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 985) (pdf)
“(and hence may mimic acute necrotizing ulcerative gingivitis – ANUG)” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 985) (pdf)
“ilateral cervical lymphadenopathy and occasionally a generalized macular cutaneous rash.” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 985) (pdf)
“he signs and symptoms usually spontaneously resolve within 7–10 days, although the disease can be severe and prolonged in immunocompromised individuals” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 985) (pdf)
HSV2
- Can give rise to a similar clinical picture to that of HSV-1 although it has been suggested that the illness may be less severe and not as prolonged as that caused by HSV-1
Secondary HSV1
“Secondary HSV-1 infection of the mouth affects about 30% of patients with a history of probable primary infection.” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 986) (pdf)
“Many patients present with a likely secondary disease, however, cannot recall having the primary disease” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 986) (pdf)
“Often patients have recurrences at the exact same site each time, presumably reflecting the location of residency of the herpes simplex virus within the trigeminal ganglion.” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 987) (pdf)
Management
“Despite the symptoms being distressing, the management of primary HSV-1 infection can usually be based upon symptomatic relief alone. Topical anti-inflammatory drugs such as benzydamine hydrochloride spray or mouthwash, or topical anesthetics, such as lidocaine (lignocaine) gel,” “may reduce painful symptoms and facilitate feeding. Systemic analgesia and antipyretics such as a nonsteroidal anti-inflammatory agent such as ibuprofen, or paracetamol can be helpful.” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 988) (pdf)
Varicella Zoster
“Varicella zoster virus (VZV, HHV-3) gives rise to a primary infection termed chickenpox and a secondary infection known as shingles. Infection is transmitted via droplets or close contact with lesions (i.e., the cutaneous rash of chickenpox).” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 988) (pdf)
Management
“Unlike primary HSV infection, antiviral therapy is almost always warranted for orofacial shingles. Oral acyclovir (e.g., 800 mg, 5 times daily for 7 days) is a typical therapy but sometimes valacyclovir or famciclovir can be used, especially if patients have difficulty in taking medication so frequently and/or the disease is atypical or prolonged.” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 990) (pdf)
Coxsackie / Hand, Foot, and Mouth disease
“Hand, foot, and mouth disease (HFMD) is a common viral and exanthematous illness, typically affecting infants and children between 3 and 10 years of age. The most common virus involved is coxsackie virus A16, but other viruses such as coxsackie viruses A5, A7, A9, A10, B2, B5, and enterovirus 71 can also cause HFMD (Solomon et al. 2010).” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 994) (pdf)
“The transmission takes place through fecal-oral contact or via inhalation of respiratory droplets; however the direct interaction with cutaneous lesions can also cause disease transmission.” (“Contemporary Oral Medicine: A Comprehensive Approach to Clinical Practice”, 2019, p. 994) (pdf)