HSV is a genus of herpes simplex viruses in the alpha subfamily of the human herpesviridae family, and its genome is a double-stranded linear DNA, which exists in both circular and linear forms in the body. HSV-1 is mainly found in the skin and mucous membranes above the face and waist and in the central nervous system, and occasionally in the external genitalia; HSV-2 is mainly found in the genitalia and in the skin and mucous membranes below the waist and occasionally in the oral cavity. The important feature of HSV infection is that the virus can be present in the body for a long time.
Herpes simplex virus (HSV) infections occurring in the oral cavity are called oral herpes simplex, and are transmitted by direct contact with HSV-infected patients and carriers, mainly through droplets, saliva and herpes fluid, but also indirectly through eating utensils and clothing.
Reminder: Herpes simplex virus infection is very common, some infected people are not symptomatic, are asymptomatic virus carriers, are hidden dangerous elements, if they kiss the baby, the baby will also be infected. Especially in the case of herpes in the mouth and lips, you should never kiss your baby!
There are primary herpes simplex infection and recurrent herpes simplex infection in oral mucosa lesions caused by herpes simplex virus infection.
Pathology] After the virus invades the mucosal epithelial layer, the epithelial cells are provoked and swell, forming vacuoles with a large amount of exudate inside the vesicles, and inclusion bodies can be found in the affected cells. If there is secondary infection, there is a significant inflammatory response in the lesion area.
Don’t move the stomatitis or something but on fire.
Primary herpetic stomatitis
It is caused by herpes simplex virus type I, mostly manifested as acute herpetogingival stomatitis. It is more common in children under 6 years of age. It is especially common from 6 months to 2 years of age. This is because the infant is born with antibodies to herpes simplex virus type I from the mother’s passive immunity, which gradually disappears between 4 and 6 months and does not produce significant antibodies until 2 years of age.
Adults can also develop the disease, but less frequently, and most primary infections are not clinically significant. 70% to 90% of adults have been infected with HSV-Ⅰ.
There are four periods of disease onset.
1, the prodromal phase: the onset of the disease is often preceded by a history of contact with patients with herpes disease. After an incubation period of 4-7 days, acute symptoms such as fever, headache, fatigue, generalized muscle pain, sore throat, swollen lymph nodes in the neck, and tenderness appear. The child salivates, refuses to eat, and is irritable. After 1 to 2 days, the oral mucous gingiva and gingival margin are widely congested with blood and edema.
2, blistering phase: clusters of pinhead-sized blisters appear on the oral mucosa, with thin, transparent walls, easily broken and forming superficial ulcers. Herbs can occur in any part of the oral mucosa, clusters of distribution, adjacent to the molar (adults in the premolar area) of the palatal side of the mucosa is particularly obvious. Fever gradually decreases as oral symptoms increase.
3, vesicular phase: clusters of small blisters can cause large areas of vesicles after ulceration, and can cause secondary infection, covered with yellow pseudomembrane. The lip and perioral skin can also have similar lesions, and scabs are formed after the blisters break down.
4. Healing period: The vesicular surface gradually shrinks and heals.
The entire course of the disease is 7 to 10 days.
Recurrent herpetic stomatitis
After the primary herpes infection has healed, recurrent damage may occur in 30 to 50% of people. In general, recurrent lesions are lighter than primary lesions and are dominated by local symptoms, often occurring on the lips or perioral area of the mouth in adults.
Features.
1, always starts with multiple clusters of blisters.
2. The damage always recurs at or near the location of the original episode.
3. During the prodromal phase, the patient may feel mild fatigue and discomfort, with symptoms such as itching, increased tension, burning, and tingling at the site where the recurrent damage will occur.
4. Within a few hours, blisters appear surrounded by mild erythema. Typically, the blisters can last up to 24 hours, followed by rupture, erosion, and crusting.
The duration of the disease is about 10 days, but secondary infection often delays healing. After healing, no scar is left, but there may be pigmentation.
5.Factors that induce recurrence include local mechanical stimulation, cold, sunlight exposure, etc. Emotional factors can also contribute to recurrence. A few recurrences can damage the gums and hard palate.
If necessary, scrape the herpes substrate for examination and see balloon-like degeneration with reticular degeneration, multinucleated giant cells, and intranuclear chromophores. The potency of the herpes simplex virus antisubstrate may be determined to assist in the diagnosis.