Herpetic stomatitis is an infectious disease provoked by the herpes virus. It is explained by contact with simple herpetic viruses. Most often, the disease is provoked in children from one year to five years of age, but it also occurs in adolescents, adults. As a rule, the foci are localized on the mucosa of the oral cavity, lips. Possible red border of the lips, redness of the skin near the mouth. The disease can proceed easily, a moderate or severe form is possible.
How to notice?
Symptoms of herpetic stomatitis include fever. If the disease is easy, the fever is subfebrile, with a more complex version, an increase of up to 40 degrees is possible. The patient has intoxication, expressed by lethargy, loss of appetite, sleep disturbance and upset gastrointestinal tract.
A symptom of herpetic stomatitis indicating the need for treatment is larger than the norm, the size of the lymph nodes. This area responds with soreness. As a rule, the reaction of the lymph nodes is fixed earlier than rashes appear on the oral mucosa.
Clinic of the disease
A good picture of the clinical picture is provided by photos published in specialized medical guides: herpetic stomatitis in catarrhal form is usually accompanied by erosion near the edge of the gums. On the mucous membranes, numerous foci of erosive damage are possible - often their number exceeds ten. Shapes are usually a circle or an oval, the diameter is from a millimeter to five. It is possible to merge areas, which leads to the formation of a large lesion. The outlines in this case are polycyclic. As a rule, stomatitis provokes painful areas of violation of the integrity of the mucous membranes. These areas are covered with fibrinous secretions, have a yellowish shade of gray, along the edges are outlined by a bright red rim.
In the portfolio of clinics dealing with viral diseases, you can see photos of herpetic stomatitis in children. Studying them, it can be noted that the patient is characterized by numerous rashes in the form of small blisters on the skin, on the red border surrounding the focus of erosion. The contents of the blisters are a transparent substance, the inclusion of blood is possible if the pathology is severe. When the rash is opened, an ulcer appears, with time a crust forms on its surface.
Diagnosis
If you suspect acute herpetic stomatitis, you must consult a doctor to determine the exact diagnosis and choose the optimal treatment program. The doctor collects the medical history, clarifies the general characteristics of the patient (first of all, age), and studies the clinical manifestations in the oral cavity. Scraping is taken from areas affected by erosion for cytological examination. Samples must be taken in the first seven days from the formation of the outbreak. If the cause of the disease is a herpetic virus, the resulting organic tissues will contain multinucleated giant cell formations.
During histological examination, herpetic stomatitis will manifest itself as intraepithelial cavities and dystrophic processes proceeding according to the balloon scenario - they cover a spiky epithelial cell layer.
What to do?
How to treat herpetic stomatitis, the doctor will tell you when the diagnosis is confirmed. The doctor will choose the optimal medical course. It includes antiviral drugs if the patient seeks help in the first week from the onset of the disease. Popular options are medicines “Acyclovir”, “Famciclovir”, “Bonaphton”. In tablet form, the preparations are used per tablet five times daily. The duration of the program is five days. If there is no reaction, you need to see a doctor to replace the drug with a more effective one for a particular case. Perhaps the local use of antiviral agents in the form of ointments, gels, applications.
At elevated temperatures, the patient is prescribed drugs to reduce it and relieve pain in areas damaged by the virus. As a rule, the treatment of herpetic stomatitis involves the use of paracetamol, Panadol, Efferalgan, Tylenol. If the patient is a child, it is recommended to use suspensions and syrups, adults are shown tablets. Dosage is determined based on age and weight, the strength of the manifestations. For example, babies are prescribed paracetamol 0.15 g three times daily.
What else will help?
Treatment of herpetic stomatitis usually involves the use of antihistamines. Syrups are shown to children, tablets to adults. Popular names are Tavegil, Claritin. You can use Suprastin and Fenkarol.
To increase the immune status, it is recommended to use "Imudon". This is a complex antigenic drug complex, under the influence of which the phagocytic effect of secretions of the salivary glands is enhanced, the concentration of lysozyme in secretion increases. "Imudon" is available in the form of tablets intended for resorption, and is used in food up to eight times a day. Another good remedy is sodium nucleinate.
It is also recommended the use of vitamin complexes that increase the body's ability to fight viral cells. In case of herpetic stomatitis, “Ascorutin” is considered to be especially useful, it is prescribed for both minors and adult patients. It is recommended to use vitamin C daily - at least three times a day, 0.1 g or more. Not only pharmaceutical products are good, but also natural sources of ascorbic acid.
Local therapy
To ease the manifestations of acute herpetic stomatitis in children and adults, local anesthetics are used. The most popular option is the application of pyro-, trime-, lidocaine. For lotions use a two percent solution. Apply the application half an hour before a meal.
After each meal, it is necessary to treat the oral cavity with disinfectants. Solutions of chlorhexidine, furatsilina or potassium permanganate are used. Such can be bought at any pharmacy, and the price for them is quite low, so something from the listed list is in the medicine cabinet of almost any person.
To clean the foci of erosion from necrotic tissues, you can use tools with enzymes. Trypsin and chymotrypsin solutions have proven themselves well. To stimulate the regeneration of the epithelium, it is recommended to use oily vitamin solutions, natural oils - sea buckthorn, rosehip. Stimulate the restoration of the epithelial integument “Solcoseryl”, “Tykveol” and “Carotolin”. On sale, the preparations are represented by ointments, gels and special pastes, which are characterized by increased adhesive ability when applied to the mucous membranes of the oral cavity.
What else to try?
Treatment of herpetic stomatitis in children and adults usually involves the use of local agents to stop viral activity. Such medications are most effective in the first week after the onset of primary symptoms. You can use ointments, make applications with therapeutic solutions. The duration of the procedure is about half an hour, the frequency is up to seven times daily, the duration of the program is about a week. Popular remedies are Acyclovir, Bonafton in the form of ointments, as well as helepin, alpizarin ointment and containing florenal. For local use in order to stop the focus of viral activity, leukocyte interferon is used. The drug is made in the form of a solution for applications or ointments.
To inhibit the activity of inflammatory processes in herpetic stomatitis in adults and children, they use "Holisal" gel "Mundizal". As part of these medicines, there are salicylates, due to which the pain syndrome is weakened, the inflammatory process becomes less active. Means inherent antimicrobial effect.
For faster healing, aniline dyes can be used. The most commonly used alcohol solution, popularly known as greenback. They are treated with a red border of lips and damage to the skin.
Course Nuances
With herpetic stomatitis, it is necessary to eat grated food. Do not use products that are harmful to the oral mucosa or irritating tissues. It is shown to drink plenty of pure water without additives.
When following the program developed by the doctor, the prognosis is favorable. As a rule, a complete cure is possible in a week or two. Scars usually do not form.
Chronic illness
In this form, herpetic stomatitis in children and adults is quite widespread. It appears if a person at some point was infected with a simple herpetic virus. In the absence of antibodies in the circulatory system that can inhibit viral activity, a relapse of the disease is observed. The likelihood of occurrence is especially high in conditions of lowered immune status, to which external aggressive factors, local ones, can lead. Often, outbreaks are observed with hypothermia, poisoning, a stressful situation, against the background of another disease.
Specialized studies have identified five stages of the development of the disease. First, the incubation step, then the prodromal period, after which the disease develops, fades away, and recovery or convalescence sets in. At the second stage, the patient feels unwell, the lymph nodes grow, the temperature rises above normal, saliva is actively generated, and inflammation can be seen on the mucous membrane of the mouth.
Over time, separate vesicles appear, rashes adjacent to each other and soon opening. This area becomes a hotbed of erosion. The edges of the sites are scalloped, the foci are painful, localized on the mucosa in the most inflamed places.
Case features
The severity of chronic herpetic stomatitis in children and adults is determined by the general condition of the person, the number of foci, the degree of their defeat. With a low immune status, the disease is difficult. This is also characteristic of those who suffer from several chronic diseases. For this group, frequent relapses are characteristic, due to which the form can be converted into a persistent chronic one.
It is important to distinguish between aphthous and chronic herpetic stomatitis. Manifestations of the disease are somewhat similar to allergic reactions, erythema, syphilis. To clarify the diagnosis, the doctor evaluates the clinical manifestations, makes a cytological analysis of the substance obtained from the vesicles.
How to help the patient?
If herpetic stomatitis proceeds in a chronic form, therapy is aimed at preventing relapse. It is necessary to timely identify and treat any infectious, inflammatory foci in the body (regardless of the area of localization). Particular attention is paid to the oral cavity. The probability of rashes is increased if the lips are dry, covered with cracks, so it is important to deal with these local phenomena.
With an increased relapse rate, an antiherpetic multivirus vaccine will benefit. Application is possible only under the supervision of a doctor, in accordance with the scheme recommended by the manufacturer, course.
Good results are shown by the use of gamma globulin, deoxyribonuclease. The patient is shown vitamin C in large doses. In some cases, it is reasonable to resort to helium treatment. To do this, use special devices - neon lasers.
Tender age: features
About 80% of children at some point in childhood suffer from herpetic stomatitis. Infection occurs not only in close contact with the virus carrier, but also in an aerosol manner. Usually, primary infection occurs when the child’s immunity is weakened. This leads to an acute form.
To clarify the case, the child must be shown to the doctor. The doctor will examine the patient, interview parents about the appearance of the disease. To check the diagnosis can be sent for analysis: PCR, immunofluorescence, virological analysis.
Usually, a child’s disease begins acutely, the temperature rises, ulcers and vesicles form in the mouth. These areas are painful. Saliva becomes more viscous. With stomatitis due to the herpetic virus, the child is drawn to sleep. A possible complication is gingivitis.
Treatment of children: features
To alleviate the condition of the patient, the doctor prescribes lotions, rinses, ointments. If a very small child falls ill, parents will have to treat the affected areas with cotton swabs, as the kids have not yet learned to rinse their mouths. The main objective of the course is to relieve pain, ease the general condition, prevent the spread of the disease and stimulate regenerative processes.
As a rule, the first measures are disinfection. You can use pharmaceutical products or folk remedies - infusions, decoctions of medicinal plants. Of the pharmaceutical products, “Furacilin” and “Rivanol” are most often used. The treatment is repeated every three hours. A good result shows Miramistin. If the baby already knows how to rinse his mouth, the procedure is carried out four times daily. Rinse time is one minute. An alternative method of use is spraying the mucous membranes of the mouth with a spray.
Continuation of the course
After cleaning the oral cavity and disinfecting the mucous membranes, ointment can be applied to relieve pain and stop the activity of pathological microorganisms. Apply oxolinic, bonaphthonic, interferon ointment. Sometimes doctors recommend stopping on ointments with florenal, tebrofen.
To speed up regeneration, pharmacy aerosols and ointments are suitable. You can use "Tantum Verde" and "Proposol." The drug "Ingalipt" has proven itself well. When the most acute period has passed, you can use dogrose and sea buckthorn oil, juice and pulp of aloe leaves as a wound healing agent.
If it is impossible to get to the doctor, the first signs of herpetic stomatitis are barely noticed, it is worth using ointments to relieve symptoms. Suitable local analgesic drugs - "Kalgel", "Holisal". Children are allowed funds "Kamistad" and "Dentinoks."
It is possible to stimulate the immune system and increase the general status of the body using immunomodulating agents. Such are more indicated if the disease flows into a chronic form. Immunomodulators are an effective method of preventing relapse. A popular remedy is Amiksin.
Treatment features
To increase local immunity, you can use special children's toothpastes. They are sold in almost any pharmacy and contain lysozyme, lactoferrin, glucose oxidase. To quickly neutralize the virus, you can use "Zovirax". Tablets are shown to children orally with four-hour intervals, the dosage is 0.2 g. The duration of the program is five days. You can apply ointment, cream. If stomatitis is very difficult, it is necessary to use "Acyclovir" intravenously. The drug is administered using a dropper under the supervision of a doctor.
Antipyretic drugs are prescribed if the temperature rises to 38 degrees and above. At lower rates, it is not necessary to lower the temperature, since antipyretic drugs inhibit the production of interferon, and therefore weaken the activity of the immune system.