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- Inflammation of the mucous membranes of the mouth including the cheeks, gingiva, tongue, lips, hard palate, and soft palate
- Also called gingivostomatitis when the gums are specifically involved
- Enteroviruses (causing herpangina and hand-foot-and-mouth disease) and herpes simplex type 1 (HSV-1) are the most common infectious causes of stomatitis.
- Recurrent aphthous stomatitis (or canker sores) is also common in children. The etiology of recurrent aphthous stomatitis is unknown.
- Enteroviruses (including coxsackie viruses)
- Infections are more common in the summer and fall months in temperate climates but occur year-round in the tropics.
- Herpangina and hand-foot-and-mouth disease are most common in infants, toddlers, and young children.
- Infections occur throughout the year.
- Most primary HSV infections in childhood after the neonatal period are asymptomatic.
- Primary herpetic gingivostomatitis is most common in infants, toddlers, and young children.
- Recurrent HSV-1 infections can occur any time after the primary infection.
- Seroprevalence of HSV-1 in the United States: >25% by age 7 years; >40% by age 21 years
- Recurrent aphthous stomatitis is most common in older children and adolescents.
- Wash hands after contact with the infected individual to help prevent spread of viral stomatitis.
- Disinfect surfaces, toys, and other objects used by an infected child to decrease spread of illness. Enteroviruses can survive on surfaces long enough to allow transmission of infection.
- Use contact precautions for hospitalized patients with viral stomatitis.
- Enteroviral infections:
- Spread by fecal–oral and respiratory routes; can also be passed from mother to infant prenatally, in the peripartum period, and perhaps via breast milk
- Result in viremia which spreads virus to target organs
- HSV-1 infections:
- Spread via contact with mucous membranes or open skin
- Travel from the skin to the trigeminal sensory ganglion where infection persists for life; reactivates causing recurrent symptoms
- Herpangina—most often coxsackie A viruses; also caused by other enteroviruses
- Hand-foot-and-mouth disease—most often coxsackie A viruses; also coxsackie B, enterovirus 71, and echoviruses
- Primary herpetic gingivostomatitis—typically HSV-1; can also be caused by HSV-2
- Recurrent aphthous stomatitis—possible causative factors: physical and chemical trauma, foods, nutrient deficiencies, immunodeficiency, systemic illness, infections, genetic predisposition, smoking, stress, medications
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