Otitis

Herpes (herpetic) stomatitis in children. Treatment of herpetic stomatitis in children

Sometimes small ulcers form on the mucous membrane of the child’s mouth, which cause great discomfort. Painful sensations when chewing food, when swallowing water, the baby is capricious and does not sleep well. Most likely, the reason for everything is herpetic stomatitis.

Herpetic stomatitis is the most common type of inflammation of the oral mucosa caused by the herpes virus.

If it enters the body, the herpes virus can cause damage to the skin, mucous membranes, eyes, nervous and cardiovascular systems.

However, the most common area of manifestation of the herpes virus is the oral cavity, lips, nose and skin around the mouth.

Video: childhood stomatitis

Causes

The only cause of herpes stomatitis is infection with the pathogen.

Certain categories of children are more susceptible to it:

children with weakened immune systems;
children with chronic diseases;
children with HIV;
children with diabetes and other endocrine diseases.

Pathogen

The causative agent is a virus herpes simplex.

According to its antigenic properties, it is divided into 2 types:

causes damage to the oral mucosa;
causes damage to the genital organs.

Primary infection usually occurs between the ages of 1 and 3 years, since during this period babies have not developed their own body defense systems, and the antibodies received from the mother disappear by the age of one year, and the child becomes susceptible to infection.

Video: herpetic infection

Routes of infection

The source of infection is a sick person (or a virus carrier).

This could be relatives, other children, and service personnel. Infection occurs by airborne droplets, through household items and contaminated toys.

Epidemic outbreak in kindergarten can affect up to 75% of children, the virus is so strong.

Symptoms

Herpetic stomatitis in children is very difficult to recognize in the first 2-3 days of the disease, since the rash does not appear immediately.

Symptoms in children are as follows:

a sharp increase in temperature (above 370 - 390 C);
enlargement of the submandibular and cervical lymph nodes;
swelling and redness of the soft tissues of the oral cavity;
saliva constantly flows from the baby’s slightly open mouth;
general poor health of the child: he becomes capricious, restless;
On the 2nd–3rd day of the disease, small blisters appear, which cause painful sensations at the baby's.
after the blisters burst, characteristic erosions and ulcers appear, which take quite a long time to heal (3–5 days);
erosions in the oral cavity become covered with a white coating and gradually clear and epithelialize;
the child may refuse to eat all this time due to painful sensations in the mouth.

Classification

Herpetic stomatitis is classified depending on the course and severity of the disease.

With the flow

Depending on whether the disease first appeared or whether it relapsed, acute and chronic herpetic stomatitis are distinguished.

Acute form in children

It develops when the herpes virus first enters the body. The incubation period can last from 2 days to 3 weeks, depending on the immunity of its carrier. In children under one year of age, this period is up to 3 days.

Accompanied elevated temperature body, hyperemic oral mucosa, single or grouped lesions, inflammation and bleeding of the gums.

Depending on the severity, the rash may also appear on the skin around the mouth. It is better to isolate a sick person due to the high degree of contagiousness.

Video: acute herpetic stomatitis

Chronic relapsing

This type of stomatitis occurs when:

exacerbation of chronic diseases;
weakened immune system;
frequent ARVI;
regular damage to the soft tissues of the oral cavity (with traumatic bite, biting lips and cheeks);
the presence of carious cavities.

Usually herpetic rashes in the chronic form of stomatitis, they occur on the tongue, lower and upper palate, and cheeks. Lesions appear in groups, eventually merging and turning into very painful erosions.

The main difference from the acute form is the absence of other manifestations of the disease other than rashes.

Treatment is usually carried out in the same way.

By severity

Acute herpetic stomatitis occurs in three forms of manifestation: mild, moderate and severe.

The condition is assessed by the nature and severity of symptoms.

Light form

Light form is different minor violation child's condition:

low-grade body temperature (37–37.5°C);
catarrhal gingitis or mild inflammation of the mucous membrane at the site of the future rash may occur;
pain when eating;
During the rash, the mucous membrane is hyperemic and swollen, and individual erosions appear, covered with a fibrous coating.

Rashes appear once and new elements no longer appear. Changes in the blood are usually absent. The duration of the disease is 4–5 days.

Photo: Light form herpetic stomatitis

Moderate form

Already in initial period is bright enough severe symptoms toxicosis and damage to the oral mucosa:

deterioration in the child’s well-being: weakness, loss of appetite, the baby becomes capricious;
catarrhal tonsillitis is possible, there may be symptoms of acute respiratory infections;
enlargement and pain of the submandibular lymph nodes;
low-grade body temperature.

As the disease progresses, the following are observed:

nausea;
headache;
pale skin;
temperature rise to 38–39°C;
rash of lesions in the oral cavity (10–25 pieces), on the skin of the perioral area;
increased salivation;
gingitis becomes pronounced, the gums bleed.

With this form of the disease, the rashes often recur.

The duration of the period of extinction of the disease depends on the resistance of the baby’s body, the condition of the teeth and the rationality of therapy.

Healing of the lesions lasts about 4-5 days. Gingitis, lymphadenitis and bleeding gums last longer. Observed in the blood increase in ESR up to 20 mm/hour, often - leukopenia, less often - slight leukocytosis.

Severe form

Acute herpetic stomatitis in children in severe form is quite rare.

The initial period is characterized by the presence of all the signs of an incipient acute infectious disease:

apathy;
headache;
adynamia;
increased sensitivity of the skin.

Signs of damage to the cardiovascular system are often observed:

heart rhythm disturbances;
demotion blood pressure;
muffling of heart sounds.

Some children develop:

nausea and vomiting;
nosebleeds;
inflammation and enlargement of the submandibular and cervical lymph nodes.

As the disease progresses, the body temperature rises to 39–40°C, a slight runny nose, slight coughing may occur, the child’s eyes are sunken, and the lips are parched, dry and bright. The mucous membrane in the oral cavity is severely hyperemic, gingitis is pronounced.

After 2 days, up to 25 lesions appear in the oral cavity. Often, rashes in the form of herpetic blisters appear in the perioral area, on the skin of the eyelids, and the conjunctiva of the eyes. In the oral cavity, the rashes recur; at the height of the disease, up to 100 of them form.

Groups of elements merge, and large areas of necrosis of the mucous membrane are formed. Appears from the mouth putrid smell, profuse salivation with blood admixture.

When a severe form of herpetic stomatitis is observed, treatment at home becomes ineffective. The active participation of the dentist and pediatrician is necessary, so hospitalization is recommended.

Diagnostics

The diagnosis is made based on clinical picture diseases. Due to the fact that virological and serological methods The research is quite lengthy, Lately The immunofluorescence method is becoming popular. In addition, a clinical blood test is performed.

Treatment

Treatment for acute herpetic stomatitis in children should begin immediately, before the disease develops into a more severe form.

results medical research showed that with this disease, clinical recovery occurs much earlier than the baby’s immune system is restored.

Therefore, treatment should not be limited only to direct treatment of stomatitis: it is necessary to obtain recommendations from a pediatrician, dentist, immunologist and neurologist.

Treatment should be aimed at both healing the ulcers and restoring the body's defenses. The method of treatment is determined by the degree of its severity. The choice of therapy also depends on how quickly the parents noticed the disease and sought help from a specialist.

Local

Local treatment is aimed at relieving or reducing pain in the oral cavity, as well as preventing recurrence of rashes and healing existing lesions.

Antiviral drugs are used for these purposes:

0.25% oxolinic ointment;
0.5% tebrofen ointment;
Zovirax;
Interferon solution.

These medications should be used 3-4 times a day. They should be applied both to the affected area and to those areas of the mucous membrane that are not yet affected by the disease.

Photo: Antiviral drugs - Zovirax and Oxolinic ointment

These drugs can be discontinued during the period of extinction of the disease.

In addition, the following are suitable for local therapy:

oil solutions A and E;
sea buckthorn oil;
rosehip oil;
oxygen cocktail.

General

General treatment should include:

Reception antiviral drugs inside. It can be:
- acyclovir;
- Zovirax;
- alpizarin.
Stimulation of immunity. The following drugs may be suitable for this:
- imudon (for children over 3 years old);
- levamisole;
- immunal solution (for children over 1 year);
- Immunal tablets (for children over 4 years old).
Vitamin therapy. It should include:
- B vitamins;
- vitamin A;
- vitamin C;
- folic acid;
- minerals (iron, zinc).

The treatment regimen is prescribed by the doctor depending on the severity of the disease and the age of the child.

Photo: Antiviral tablets Alpizarin and Acyclovir

Video: vitamins for children

Symptomatic

Symptomatic treatment of herpes stomatitis involves local anesthesia. To do this, it is recommended to spread painful areas oral mucosa with an anesthetic solution or gels for teething gums based on lidocaine (Kamistad, Kalgel).

Photo: Pain relieving gels Kamistad and Kalgel

When the inflammation passes, wound-healing drugs are used that help restore the oral mucosa (solcoseryl, vinylsol, panthenol).

To reduce high temperature and pain relief are used:

preparations with ibuprofen - Ibufen, Nurofen;
preparations with paracetamol - Calpol, Panadol
preparations with nimesulide - Nimesil, Nise.

The choice of drug, as well as its form and dosage, must correspond to the age of the child.

Diet

Due to the characteristics of the current of this disease great importance has a diet during treatment. Food should be complete, rich in vitamins and all nutrients.

Must be used:

fresh fruits and vegetables, berries – neutral in taste;
juices (especially carrot), fruit drinks;
dairy products;
dishes from minced meat(in limited quantities);
tea, rose hip decoction, water.

salty;
sweet;
sour;
bitter.

Before feeding the child, it is necessary to numb the oral mucosa with a 2-5% solution of anesthetic emulsion.

Food should generally be liquid or semi-liquid and not irritate the mucous membranes. The same applies to the temperature of the food - it should not be hot or cold, as this can cause additional irritation to the oral cavity.

The child should drink enough fluid, especially if intoxicated.

Prognosis and possible complications

Once it enters a child’s body and causes a primary herpetic infection, the virus remains latent for life or sometimes causes relapses of the disease (chronic recurrent stomatitis).

Herpetic stomatitis in a child can turn out like this serious complication, such as herpetic keratoconjunctivitis. This is a dangerous disease that can lead to blindness.

In addition, if your child refuses to eat or drink because the mouth is sore, it can lead to dehydration.

Prevention

The most effective ways prevention:

hardening the child;
thorough oral hygiene;
balanced diet;
isolating the child from sick people.

These measures, of course, will not be able to protect a child from infection one hundred percent, but will reduce the possibility of complications and the development of a severe form of the disease.

Photo

On days 2–3, herpetic stomatitis gives rise to rashes in the form of ulcers. At this time, making a diagnosis is not particularly difficult.

FAQ

How many days is a child contagious?

On average, the duration of the disease is 8 days, during which a child can infect another person through close contact. After this time, the baby ceases to be dangerous to others.

– spicy inflammatory lesion oral mucosa caused by the herpes simplex virus. Herpetic stomatitis in children is manifested by fever, lymphadenitis, salivation, nausea, vesicular rashes, erosions and aphthae in the oral cavity, and loss of appetite. The diagnosis of herpetic stomatitis in children is made according to anamnesis, clinical picture, cytological examination, RIF, PCR, ELISA. Treatment of herpetic stomatitis in children includes antiviral, desensitizing, immunocorrective therapy, local treatment oral cavity, physiotherapy.

General information

herpes viral infection, which occurs with primary damage to the oral mucosa and symptoms of general intoxication. In pediatrics and pediatric dentistry, herpetic stomatitis ranks first among inflammatory diseases of the oral cavity in children, accounting for almost 80% of cases. Herpetic stomatitis is considered as a manifestation of the first contact of the child’s body with the herpes simplex virus type I. Most often, herpetic stomatitis occurs in children from 1 to 3 years old, which is associated with their age-morphological characteristics, a decrease in the level of transplacental antibodies and the immaturity of cellular and specific immunity. Herpetic stomatitis can also be observed in children of the first year of life, who have been bottle-fed from the first months.

There are two types of herpetic stomatitis in children: primary acute and chronic recurrent. Children who have had acute herpetic stomatitis become asymptomatic virus carriers or suffer chronic type infections. Herpetic stomatitis in children may be accompanied by lesions nervous system And internal organs, oppression immune reactions, therefore, requires serious attention from pediatricians, pediatric dentists, pediatric immunologists, pediatric neurologists and other specialists.

Causes of herpetic stomatitis in children

HSV type I is a DNA virus belonging to the Herpesviridae family and clinically manifested by rashes on the skin of the face and oral mucosa. Once in the child’s body, HSV actively multiplies in epithelial cells and surrounding lymph nodes (most often, submandibular), penetrates into the bloodstream (primary viremia), and from there to various organs (liver, spleen, etc.) with subsequent reproduction and secondary viremia. At the next stage, damage to the skin and mucous membranes of the lips, oral cavity and pharynx is observed with the development of symptoms of herpetic stomatitis in children. Herpes infection can pass into a latent form with lifelong persistence of the virus in the nerve ganglia.

The source of the pathogen is children with acute herpetic stomatitis, adults with recurrent herpes of the lips and virus carriers. Herpetic stomatitis is very contagious: HSV type I can be transmitted to healthy children through household contact (through kisses, toys, household items) and by airborne droplets (when coughing and sneezing), vertical transmission from mother to fetus is possible (with relapse of herpes with viremia in pregnant).

Treatment of herpetic stomatitis in children

In uncomplicated herpetic stomatitis, treatment is outpatient; in complicated cases and in children of the first three years of life, hospitalization may be required. Children with herpetic stomatitis are advised to rest in bed, drink plenty of fluids, pureed, warm, non-irritating food, and use separate utensils and hygiene items.

Complex treatment of herpetic stomatitis in children (general and local) is selected depending on the period of the disease and the severity of symptoms. For fever and soreness, paracetamol and ibuprofen are prescribed; to relieve swelling - antihistamines (mebhydrolin, clemastine, hifenadine). Systemic etiotropic therapy (acyclovir, interferon) is more effective in the initial period. For the purpose of immunocorrection, lysozyme, thymus extracts, and gamma globulin injections are prescribed.

Local treatment of herpetic stomatitis in children is carried out by a pediatric dentist and a pediatric periodontist. The oral mucosa is treated daily with antiseptics, anesthetics, herbal decoctions, and lubricated with antiviral drugs. For moderate forms of herpetic stomatitis in children, solutions of proteolytic enzymes (trypsin, chymotrypsin) are used to cleanse the surface of the mucosa from necrotic masses.

During the period of epithelization of erosions, keratoplasty agents are used (vitamins A, E, rosehip and sea buckthorn oil). Physiotherapy for herpetic stomatitis in children is prescribed from the first days of the disease (Ural irradiation, infrared irradiation). For recurrent herpetic stomatitis in children, courses of restoratives (vitamins C, B12, fish oil) and a high-calorie diet are indicated.

Forecast and prevention of herpetic stomatitis in children

Herpetic stomatitis in children in most cases ends with clinical recovery after 10-14 days. In severe cases, there is a risk of complications in the form of herpetic keratoconjunctivitis, herpetic encephalitis, and generalization of infection.

It is impossible to prevent children from coming into contact with herpesvirus infection, because HSV carriage among the adult population is 90%. Prevention of herpetic stomatitis may include isolating a sick child from healthy children, limiting contact with adults in the active phase of infection, observing personal hygiene rules, hardening, and physical exercise.

Reading time: 10 minutes

Has your child begun to be capricious and eat poorly, and a rash in the form of small blisters has appeared in the mouth? There is a high probability that this viral infection, which causes not only inflammatory processes in the oral cavity, but also general intoxication of the body. Herpetic stomatitis in children is a common disease that requires timely diagnosis and proper comprehensive treatment.

What it is

Herpetic stomatitis is an infectious lesion of the oral cavity that occurs when a child’s body first comes into contact with the herpes simplex virus type 1. This infection develops in children with weakened or unformed cellular and specific immunity, therefore it is more common between six months and three years of age.

Depending on the character infectious process There are acute and chronic recurrent types of herpetic stomatitis in children. A child who has had an acute form of the disease may become an asymptomatic carrier of the virus or suffer from a chronic form of this infection. To understand in more detail the features of the course, as well as the treatment of herpetic stomatitis in childhood, watch the video with Professor of the Department of Therapeutic Dentistry S.Yu. Stakhova.

Causes and symptoms of herpetic stomatitis

Herpes simplex virus type 1 (HSV-1), the causative agent of the disease, enters the child’s body mainly through the skin and mucous membranes upon contact with a sick person or a virus carrier, through household or airborne droplets. After penetration into the body, it begins to function inside the cells, actively multiplying, using the resources and components of the cells. Activation of symptoms is associated with intensive reproduction of the virus, which manifests itself in a mild, moderate or severe form of the disease.

Clinical manifestations of herpetic stomatitis in children occur if there are factors that reduce resistance:

weakened immune system;
abrupt change temperature regime, overheating or hypothermia;
injuries to the oral cavity, lips;
non-compliance with sanitary and hygienic rules;
stress, nervous tension.

Mild symptoms:

the child becomes lethargic, capricious, and there is a slight increase in temperature;
redness, swelling of the oral mucosa, inflammation of the gums;
swollen lymph nodes;
a small number of painful blisters, ulcers in the mouth.

In cases of moderate severity, the following is noted:

temperature rise to 38-39 degrees;
weakness, nausea, chills, headache;
enlarged submandibular and cervical lymph nodes;
inflammation and swelling of the gums, oral mucosa;
the appearance of a rash in the form of blisters on the mucous membranes of the mouth, tongue, cheeks, lips, and skin around the mouth.

A severe form of the disease is characterized by:

high critical body temperature;
severe general condition, signs of severe intoxication;
severe headache, muscle pain;
nausea, vomiting;
low blood pressure, heart rhythm disturbances;
lymphadenitis of the cervical, submandibular lymph nodes;
multiple painful rashes in the form of blisters, erosions that spread to the area around the mouth, wings of the nose, eyelids, and conjunctiva of the eyes.

Bubbles characteristic of stomatitis appear in a group and tend to merge. After the herpetic vesicle bursts, a focus of painful erosion forms. If there are no complications, then scars do not form on the affected areas of the skin. Such damage to the mucous membranes and skin is typical only for this disease, therefore it is important diagnostic sign. In the photo you can see a rash typical of herpetic stomatitis.

Diagnosis of the disease is based on analysis of symptoms, clinical manifestations, as well as cytological examination of scrapings of the contents of a vesicle or erosion. The duration of the active phase of the disease depends on the general condition of the child, the timeliness of treatment measures and the severity of the disease. At mild form treatment of herpetic stomatitis takes up to 7 days, with moderate - several weeks, and severe form requires immediate hospitalization. The length of time a child develops symptoms will depend on the effectiveness of treatment measures.

Treatment of herpetic stomatitis in children

Doctors recommend that at the first signs of illness in a child, immediately contact a specialist. You will probably need to consult a pediatrician, dentist, neurologist, and in severe cases, hospitalization in a hospital. The sooner it is appointed effective therapy, the easier the course of the disease will be and the lower the risk of developing severe complications.

Herpetic stomatitis in children is treated comprehensively, in several areas:

Antiviral therapy. Aimed at neutralizing the causative agent of infection, it is carried out using drugs in the form of tablets and ointments for topical use.
Anti-inflammatory and antihistamines. Prescribed to relieve symptoms of intoxication and reduce body temperature.
Increasing the body's resistance and strengthening the immune system with the help of vitamin-mineral complexes and immunostimulating drugs.
To speed up healing, relieve inflammation and pain, gels, ointments with an analgesic effect, as well as drugs with keratoplasty properties are prescribed.

How and with what to treat

For herpetic stomatitis in children drug therapy prescribed by the attending physician, taking into account the severity of the disease, condition, and age of the child. Experts recommend to parents:

provide the baby with plenty of fluids at a comfortable temperature, balanced diet;
avoid foods that can injure the affected areas;
it is advisable to feed the baby 3-4 times a day, and not to give additional food in between, so that the time interval necessary for the effects of medications is observed;
follow the rules of hygiene and oral care to avoid attachment bacterial infection;
provide a sick child with separate dishes and toys;
treat the affected areas several times a day in accordance with the doctor’s recommendations;
do not self-medicate using information from forums on the Internet and consult a doctor at the first signs of illness.

Treatment of the oral cavity in a child with herpetic stomatitis:

Rinse. Babies do not know how to rinse their mouths on their own, so they irrigate the oral cavity by carefully tilting their heads over a basin. Older children can rinse their mouths with herbal decoctions, a water-salt solution, or medications prescribed by the pediatrician.
Treatment of areas of the mucous membranes of the mouth and skin affected by stomatitis. After rinsing, it is recommended to treat healthy and damaged areas with antiviral, analgesic or wound-healing agents. This is done using a cotton swab. It is necessary to carefully lubricate the affected areas, trying to do this carefully so that the child does not get hurt.
Lotions. Applications and lotions for stomatitis can be made if herpetic crusts form, as well as to prolong the effect of the medicine. Procedures with herbal remedies, analgesic drugs help relieve pain and inflammation. At the healing stage, it is recommended to use sea buckthorn oil, rosehip oil, and oil solutions of vitamins A and E to speed up healing.

During the period of illness, it is necessary to follow the instructions and rules for caring for a sick child, because the herpes simplex virus is highly contagious and can actively spread. For herpetic stomatitis, medications are prescribed various forms release, pharmaceutical action. The earlier treatment is started, the more likely it is that the disease will pass without complications and in a mild form, so timely contact with a pediatrician or dentist is important. We provide you with an overview of pharmaceuticals recommended by experts.

Review of pharmaceutical drugs

Holisal

Ingredients: active substances choline salicylate and cytaclonium chloride, auxiliary components.
Action: anti-inflammatory, analgesic, antiviral and antifungal.
Application: for herpetic stomatitis, children over 1 year of age are prescribed topically 2-3 times a day. It is recommended to squeeze out a 0.5 cm strip of gel onto a clean finger and gently apply it with light massaging movements to the area of the child’s mouth affected by stomatitis. It is used as an analgesic before meals, as an antimicrobial and anti-inflammatory - after breakfast, before bedtime.
Price: from 260 rubles (10 g)

Viferon

Compound: active substance Interferon alpha-2b human recombinant.
Action: antiviral and immunomodulatory.
Application: at the first signs of stomatitis, a 0.5 cm strip of gel is squeezed onto a spatula or cotton swab and applied to a pre-dried surface 4-5 times a day for 6-7 days.
Price: from 130 rubles (12 g)

Oxolinic ointment 0.25%

Ingredients: active ingredient oxolin.
Action: antiviral.
Application: for herpetic stomatitis, it is recommended only for children over 2 years old. Apply with a cotton swab or bandage 3-4 times a day to the affected areas of the mouth and lips for a week.
Price: from 20 rubles (10 g)

Acyclovir

Action: antiviral.
Application: for the treatment of herpetic stomatitis, children over 2 years old are prescribed 1 tablet 4-5 times a day, under 2 years old - half the dose. The cream is applied to the skin 5 times a day for 5-10 days.
Price: tablets 200 mg No. 20 – from 40 rubles, cream 5% 2 g – from 50.

Zovirax

Compound: active substance acyclovir
Action: antiviral.
Application: for herpetic stomatitis, children over 2 years old are prescribed one tablet (200 mg) 4 times a day or two tablets 2 times a day, children under 2 years old receive half the dose. Intravenous injections used at a dosage of 10 mg/kg with an interval of 8 hours. The cream for external use is applied to the affected areas 4-5 times a day at the first symptoms of the disease.
Price: tablets 200 mg No. 25 – from 780 rubles, cream 5% 5 g – from 185 rubles.

Immunal

Ingredients: active ingredient – plant extract Echinacea purpurea.
Action: stimulant of nonspecific immunity, increases resistance to infectious diseases, has an antiviral effect.
Application: children from 6 to 12 years old are recommended to take 1.5 ml of solution with a small amount liquids 3 times a day or 1 tablet 2-3 times a day for 10 days.
Price: tablets No. 20 – from 210 rubles, drops 50 ml – from 220 rubles.

Oil solutions A and E

Ingredients: vitamins A (retinol), E (tocopherol).
Action: keratoplasty, accelerate tissue regeneration and epithelization.
Application: local. Areas affected by herpetic stomatitis are lubricated with an oil solution of vitamins A or E several times a day for 5-7 days.
Price: vitamin E 25% oil solution – from 120 rubles (100 ml), vitamin A – from 2 rubles per 1 ampoule (10 ml).

Folk remedies

Vegetable oils, decoctions in the form of lotions, applications, rinses relieve swelling of the mucous membrane and inflammation, pain, promote healing and regeneration. But folk remedies Treatment of herpetic stomatitis cannot be an alternative to antiviral therapy. Before taking herbal remedies or using methods traditional medicine, consult your doctor. Here are a few recipes that experts recommend using along with others therapeutic measures in the treatment of this disease.

Chamomile decoction. Has anti-inflammatory and analgesic effects. To prepare the decoction, 4 tbsp. Chamomile flowers are poured into 1.5 liters of water and boiled for 5-10 minutes. After 45-60 minutes, filter. Doctors recommend using it for herpetic stomatitis several times a day for rinsing or irrigating damaged areas of the skin and oral mucosa.

Decoction of calendula flowers. Calendula relieves swelling and inflammation. To prepare the decoction, 1 tbsp. pour 1 cup of boiling water over the flowers and cover with a lid. Keep for 10 minutes on low heat and filter after 45-60 minutes. This remedy intended for rinsing and irrigating the oral cavity, and can also be used for applications to areas with herpetic blisters and erosions.

Kalanchoe juice and aloe leaf pulp. Kalanchoe juice has powerful anti-inflammatory and bactericidal properties, and is also used as an analgesic for herpetic stomatitis. The pulp of aloe leaves relieves inflammation, prevents bacterial infection and promotes tissue regeneration. The products are applied to the foci of the disease in the form of applications several times a day for 15-20 minutes.

Vegetable oils of rosehip and sea buckthorn. They contain unsaturated fatty acid, complexes of vitamins and microelements. These natural oils relieve pain, inflammation, irritation and promote regeneration and healing. The keratoplastic effect of sea buckthorn and rose hips is especially important, therefore, during the recovery stage, it is recommended to lubricate herpetic erosions or apply them as applications to the affected areas 1-2 times a day.

Solution chicken protein and water. Crude protein is mixed with 0.5 l boiled water, stir thoroughly and use for rinsing. Helps with lysozyme deficiency in the saliva of a sick child and has an analgesic effect. Use several times a day to rinse after meals.

Water-soda solution. Add a dessert spoon to a glass of boiled water baking soda and stir thoroughly. The remedy is relevant at the first signs of herpetic stomatitis in a child, when swelling and redness of the oral mucosa occurs. It is recommended to rinse your mouth with it 3-4 times a day or irrigate inflamed areas with this liquid.

Prevention of herpetic stomatitis in children

Preventive measures include avoiding contact of the child with patients and virus carriers in the active phase of the disease. Doctors also recommend following the rules of oral hygiene and, if there are traumatic factors, eliminating them in a timely manner. Good nutrition and increasing the body's resistance can minimize the risks of complications.

If your child has had herpetic stomatitis, he becomes a virus carrier, so relapses are possible. To avoid progression of the disease to chronic form, it is important to adhere general principles prevention and take measures to correct immunity.

Video: How to recognize stomatitis in a child - Doctor Komarovsky

We invite you to watch the recording of the program “Doctor Komarovsky’s School”, dedicated to the topic stomatitis. A well-known pediatrician will teach you to recognize the signs of the disease and give recommendations for treatment.

Herpetic stomatitis is an extremely common disease, especially when it comes to young children. According to statistics, this disease is one of the most common in modern pediatrics and dentistry. Therefore, it is not at all surprising that many people are interested in information about the disease.

So what is the herpetic form of stomatitis? How dangerous can the disease be? What treatment methods does modern medicine offer?

What is the disease?

Today, many people are interested in questions about this disease. What is herpetic stomatitis? How to treat this disease? What is the risk of infection?

Herpetic stomatitis - viral disease. This is one of the most common oral diseases. It is especially common in young children, whose immune system is at the stage of formation. However, cases of stomatitis in adults should not be considered rare either.

Causes of herpetic stomatitis

There is only one cause of this disease - infection of the body with the herpes simplex virus. According to the latest statistical studies, approximately 90% of the world's population are carriers of this infection. It follows that the probability of infection is extremely high.

Penetrating into the human body, the virus usually affects the cells of the mucous membranes and skin. Most often, the tissues of the oral cavity become “victims” of infection. But it should be noted that it is impossible to recover from the disease. Even after the main symptoms disappear, the virus remains in the body and may manifest itself again over time.

How is the infection transmitted? In most cases, the virus passes from person to person through airborne droplets. On the other hand, intrauterine infection is possible, as well as transmission during childbirth. Sexual transmission is also possible.

Many people are interested in questions about whether herpetic stomatitis is contagious. Yes, this disease is extremely contagious. You can catch the virus while interacting with an infected person. A household route of transmission is also possible, for example, when sharing mugs, toothbrushes, towels, etc.

Who is at risk?

Today, many people are faced with a diagnosis of herpetic stomatitis. Treatment of this disease is a pressing issue. However, it's worth understanding some additional information first.

The herpes simplex virus does not always manifest itself, since its activity is controlled by the human body's immune system. Therefore, the risk group primarily includes people with weakened immune systems.

In addition, outbreaks of herpetic stomatitis may occur against the background of some other colds, in particular influenza.

The main symptoms of herpetic stomatitis

What does herpetic stomatitis look like in a child? Many parents are interested in this question. To begin with, it should be noted that incubation period for such a disease it is 2-14 days. Then the first symptoms begin to appear.

At first the child becomes restless. He sleeps poorly, often cries and wakes up at night, and often refuses to eat and drink. In some cases, nausea may occur, accompanied by regurgitation or vomiting. You may notice an increase in the cervical and submandibular lymph nodes, pressure on which is accompanied by painful sensations.

Then they begin to appear general symptoms infectious disease. Body temperature rises to 38, less often 40 degrees. Older children complain of body aches, chills, constant weakness and drowsiness, increased fatigue etc.

In some cases, the main features are also catarrhal symptoms. In particular, in children the disease is often accompanied by a runny nose, nasal congestion, less often a cough, acute gingivitis, inflammation of the mucous membrane of the eyes, etc.

Also, herpetic stomatitis in children (photo confirms) is characterized by other symptoms. In particular, upon careful examination of the oral cavity, you may notice redness and hyperemia of the gums, which may even bleed.

First, single rashes appear on the oral mucosa. By appearance they resemble small bubbles or vesicles with thin walls and transparent contents. Their diameter, as a rule, does not exceed 2-3 millimeters. The rashes can increase in size, merge with the edges, forming quite large areas of damage. Then the vesicles begin to open - in their place, small ulcers are formed, covered with a white coating (in medicine they are called aphthae).

In most cases, the rash covers the mucous membrane of the cheeks, as well as the gums, palate and back of the tongue. However, rashes can also appear on the lips and the skin around them. The formation of vesicles is accompanied severe pain. Children refuse to eat and drink, constantly cry and complain of discomfort. Sometimes the rash spreads to the lining of the larynx, causing a sore throat and sore throat-like symptoms.

Herpetic stomatitis in a child is often characterized by an undulating course. The appearance of a rash and fever are followed by a short stable period, after which the temperature rises again and the oral mucosa becomes covered with new blisters.

Depending on the severity of the disease and the quality of the treatment provided, the erosion areas close after 7-14 days. In more severe cases, a bacterial infection may occur, which significantly complicates the situation. Herpetic stomatitis in adults looks about the same.

Modern diagnostic methods

You should immediately consult a doctor if you suspect that you or your child has acute herpetic stomatitis. Treatment in in this case can only be prescribed by a specialist and only after a preliminary medical examination.

To begin with, the doctor will try to collect a complete medical history - he needs information about whether the patient has been sick similar disease in the past, when and how symptoms appeared, what treatments were used, etc. Typically, visual inspection the oral cavity is enough to suspect herpetic stomatitis.

However, acute herpetic stomatitis in children and adults requires some additional research. After all, inflammation can be caused by another infection or even result from an allergic reaction. To confirm the diagnosis, blood or saliva may be taken for analysis. Sometimes a scraping is performed from the oral mucosa. In the laboratory, the collected samples are subject to serotological, cytological and virological studies.

If outbreaks of stomatitis occur frequently, it is necessary additional examinations, which will help to establish the cause of relapses and, accordingly, eliminate it.

Herpetic stomatitis in children: treatment

In fact, the treatment of this disease in children and adults may differ, because, as is known, small patients may not take all medications, especially when it comes to infant. In particularly severe cases, the child may require hospitalization, although most often treatment is carried out at home.

In the initial stages, doctors recommend antiviral drugs - these are mainly ointments and gels for external use. Acyclovir is considered effective, although with constant relapses, medications need to be changed from time to time, since the herpes virus tends to develop resistance to drugs.

To eliminate pain, experts recommend pain-relieving ointments, in particular those containing lidocaine. Similar drugs are produced both in the form of solutions and ointments, and in the form of aerosols. Required condition is bed rest, plenty of fluids and good nutrition - this ensures rapid recovery and prevents dehydration. Naturally, a sick child needs special diet— from the diet for a while it is necessary to exclude rough food, too cold and hot dishes. Do not forget that salt and spices irritate the mucous membrane, so they should not be used when cooking.

This is exactly the type of therapy that herpetic stomatitis in children requires. Treatment should also include restorative procedures. Oral hygiene is also extremely important, as there is a possibility of bacteria entering and ulcers becoming suppurated. If we are talking about small child, then from time to time you need to give him boiled water or chamomile decoction. Adult children can rinse their mouth after every meal.

How is stomatitis treated in adults?

Herpetic stomatitis in adults is considered a very common occurrence today. Treatment in this case also includes taking antiviral drugs. In order to cleanse the body of toxic products, sodium salicylate is prescribed. Reception is also necessary antihistamines, for example, “Tavegila”, “Suprastina” or “Diphenhydramine” - this helps relieve swelling and reduce discomfort.

Various wound healing and antibacterial ointments, including tebrofen and florenal. Experts also recommend rinsing your mouth with antiseptics - a weak solution of potassium permanganate, furatsilin or hydrogen peroxide is suitable for these purposes. Also oral cavity can be treated with sea buckthorn oil, a solution of vitamin A or E, as these agents significantly accelerate the healing of wounds and alleviate the patient’s condition.

In some cases, patients require systemic antiviral therapy, which includes taking immunomodulatory drugs, as well as vitamin complexes. Don't forget about oral hygiene.

Today's advice famous doctor are very popular among young mothers. So how does he recommend treating herpetic stomatitis in children?

Komarovsky in this case adheres to general medical tactics. To eliminate symptoms viral stomatitis the use of antiviral drugs is necessary. In order to relieve pain, you can wipe the oral mucosa with a lidocaine solution. On the other hand, the doctor does not recommend using this remedy too often, as it can be addictive.

Also, do not lubricate the mucous membrane with dyes (blue, brilliant green, etc.). The fact is that the paint hides the main symptoms of the disease, so the attending physician can easily overlook some specific signs.

In addition, the doctor strongly recommends maintaining good hygiene. If we are talking about newborn babies, then the mother must carefully monitor the cleanliness of the breast, as well as the condition of toys, pacifiers and other items, because little children love to taste everything. It is important not to allow gaps in personal hygiene for the older child. Brushing your teeth during stomatitis can turn into real torture. However, oral hygiene is extremely important, as open sores often become a gateway to bacterial and fungal infections.

Recurrent form of herpetic stomatitis

In addition to acute stomatitis, modern medicine also knows a chronic, recurrent form of the disease. This means that some patients experience stomatitis outbreaks regularly. In mild forms of the disease, rashes and mouth ulcers appear no more than 1-2 times a year. With moderate severity of the disease, outbreaks occur approximately 2-4 times a year. Severe recurrent stomatitis is accompanied by regular repetitions (more than 4 times a year), and the symptoms in this case are really severe.

The clinical picture during exacerbations looks approximately the same - a characteristic blistering rash appears on the mucous membrane of the mouth and lips. Sores soon form at the site of the rash. But body temperature, as a rule, remains normal - only occasionally minor jumps are observed. Outside of exacerbations, the patient’s health condition remains satisfactory - this is what recurrent herpetic stomatitis looks like.

Treatment during an exacerbation of stomatitis is the same as for the acute form of the disease. As for the causes of relapses, they are associated with weakening immune defense. For example, an exacerbation can be caused by severe hypothermia, overheating, prolonged exposure ultraviolet radiation, as well as vitamin deficiencies, exhaustion of the body, emotional stress, etc.

Are there any complications?

In fact, acute herpetic stomatitis can hardly be considered a dangerous disease for humans. With proper treatment, the main symptoms disappear after 1-2 weeks. However, complications with such a disease are still possible, especially if we are talking about patients with weakened immune systems or improper therapy.

The most common complication is herpetic conjunctivitis, as the infection can easily spread from the oral mucosa to the eyes. More serious illness is keratoconjunctivitis, which is accompanied by damage to the conjunctiva, as well as the mucous membrane of the eyelid. The disease is characterized by the appearance of a rash, areas of erosion and ulceration, which is extremely dangerous, as it can lead to decreased vision and sometimes complete blindness. By the way, such complications are most often diagnosed in children under five years of age.

Sometimes the herpes virus spreads throughout the body. Such generalization of infection is extremely dangerous, since the target of infection can be any organ. Often the herpes virus infects brain tissue, which leads to the development of encephalitis.

That is why this disease should never be ignored, even if it seems frivolous.

Prevention of stomatitis in children and adults

Herpetic stomatitis is an extremely common phenomenon. And, unfortunately, today there is no vaccine that would be able to completely protect a person from such a disease. And, given the number of carriers of the infection, it is also almost impossible to prevent infection.

However, there are some recommended precautions. For example, experts recommend, if possible, to avoid sharing dishes, toys and other household items with people whose herpes is in the acute stage. It is also necessary to take measures to strengthen immune system which include hardening, proper nutrition, physical activity, periodic intake of vitamin complexes, etc.

Herpetic stomatitis in children is not such a simple disease as it might seem at first glance. According to the level of severity, herpetic stomatitis in a child is divided into mild, moderate and severe. For a quick recovery and comfortable treatment of this disease, it is necessary to understand the causes of damage to the oral mucosa and make sure correct diagnosis diseases.

Herpetic stomatitis in children is primarily severe and dangerous, especially in infancy. This is an extremely serious infectious disease, in which, in addition to severe damage to the entire mucous membrane in the oral cavity, it can directly excite characteristic symptoms extreme joint intoxication of the human body, serious disruptions in the functioning of the immune and nervous systems.

Herpes in the mouth, which is a common pathogen somatic disease, long time doesn't make itself known. Most infection usually occurs in fairly early infancy.

Activation of herpes stomatitis in a child usually occurs with a significant deficiency of immunity. The virus begins to multiply successfully, and therefore the body temperature increases significantly and actively forms acute inflammation in the area of the mucous membranes of the oral cavity, painful, bleeding ulcers form on the surface, and the enlargement of the submandibular lymph nodes constantly increases.

The most significant causes of herpetic stomatitis are usually:

previous infectious diseases;
antibiotic treatment;
significant decrease in immunity;
acute lack of vitamins, lack of children's body macroelements and microelements;
very close contact with someone infected with herpes stomatitis;
current problems of immune status;
severe injuries and purely mechanical serious damage to the oral mucosa;
irrational baby food;
insufficient consumption of water and any other liquid, leading to complete drying of the oral mucosa;
poor, improper care of the child’s oral cavity.

If the mother has herpetic infection, then a newborn baby can become infected with the virus during childbirth. In young children, stimulation of the virus actively contributes to frequent illnesses.

Herpes stomatitis in children is a contagious disease and its ability to be transmitted increases significantly with periodic exacerbations. Herpes is easily transferred to completely healthy areas of your own body and is repeatedly transmitted.

Symptoms

Gradual basic onset is the most essential characteristic of herpetic aphthous stomatitis in children. The incubation stage of further formation of the disease usually varies from 2 days to 21 days.

Let's look at the symptoms of herpetic stomatitis according to severity.

Light degree:
transient inflammation of the gums, at the same time their redness and swelling;
a relatively small increase in body temperature;
a small number of rather painful ulcers;

lymph nodes become sharply enlarged.

Average degree: enough high magnification
body temperature;
the persistent presence of significant inflammatory changes on the mucous membrane in the oral cavity;
immense headache, general lethargy, vomiting, nausea; rashes in the form of blisters, usually located on the gums, on the tongue, in the area inner surface

cheeks and also around the mouth.

Severe degree:
a sharp disturbance in the general well-being of the child;
the baby’s body temperature increases significantly, to critical levels;
sudden severe headaches and muscle pains occur;
vomiting and nausea inevitably begin; cervical and submandibular lymph nodes
increase;

the rash becomes very numerous, it begins to actively spread throughout the perioral area, on the eyelids and on the conjunctiva.

According to the characteristic features, the course of herpetic stomatitis in children is clearly divided into two forms:
Acute - usually occurs suddenly, is actively developing, the somatic signs of herpes stomatitis are clearly expressed.

What does herpetic stomatitis look like in a child?

Below, in the photo you can see different localization herpetic stomatitis, which is also called herpetic gingivostomatitis.

Duration of herpetic stomatitis

The average duration of herpetic stomatitis in children is from several days to three weeks. It all depends on the complexity of the disease:

with a mild degree of illness, symptoms begin to subside after three to four days;
with moderate severity, the disease can last up to two weeks;
In case of severe illness, treatment may be delayed for several weeks. In this case, the child must be hospitalized.

Of course, the duration of the disease may directly depend on proper treatment and how timely it was started. Therefore, when herpetic stomatitis is detected in children, treatment should be started as early as possible.

Diagnostics

Based on a visual examination of the patient, having analyzed the main causes of the disease, examining the symptoms of the disease, and examining tests, an experienced specialist can easily diagnose correct diagnosis herpetic stomatitis in children.

The basis of examinations for correct diagnosis includes:

cytological examination of scrapings from the infected area of the oral cavity;
polymerase chain reaction study;
examination of immunofluorescence reaction;
virological examination;
For projective identification of this virus, immune serum can be widely used.

Infection with herpetic stomatitis must be differentiated from fungal, drug, and also allergic stomatitis; from herpetic sore throat; specific infectious diseases such as scarlet fever, chickenpox, diphtheria, measles; multiform exudative migratory erythema.

Treatment

At the first signs of illness, you must immediately contact a pediatrician at the children's clinic. Considering the severity of the disease, it is possible that the attending physician will refer you for consultation and examination to a dentist and neurologist. It is possible that hospitalization in a hospital will be prescribed.

Treatment of herpetic stomatitis in children is carried out comprehensively, in such areas as:

Antiviral drug therapy. Aimed at completely neutralizing the identified pathogen of an infectious disease. It is actively marketed using medications in the form of tablets, injections and ointments for topical use.
Anti-inflammatory and antihistamine medications. It is advisable to prescribe to relieve signs of intoxication, as well as to reduce body temperature.
Significant increase in the growth of resistance of the human body and strengthening of innate immunity. With the help of immunostimulating medications and vitamin-mineral products.
To maximize the acceleration of the final relief of the inflammatory process, healing and pain reduction, specialized gels, analgesic ointments, and keratoplasty medications are usually prescribed.

During herpetic aphthous stomatitis in a child drug therapy determined and prescribed only by the attending physician, taking into account the form of the disease, age and condition of the baby. In addition, treatment of herpes stomatitis in children may differ from treatment in adults and possible individual characteristics. Therefore, it is better to seek help from a specialist.

The standard of treatment for herpetic stomatitis is that the attending physician consistently prescribes medications various forms of serial release of pharmaceutical effects.

Drugs for the treatment of childhood herpetic stomatitis

Review pharmaceuticals with which the child may be treated, after the recommendations of qualified specialists:

Paracetamol and Ibuprofen - to lower body temperature and for pain relief;
Mebhydrolin and Clemastine, as well as Hifenadine - antihistamines for complete relief of edema;
Acyclovir and Interferon - systemic therapy, aimed at eliminating the effects of factors causing herpetic stomatitis in children;
Thymus extracts, lysozyme and gamma globulin injections are prescribed for the purpose of immunocorrection;
Vitamins C, B-12, fish fat– general strengthening, high-calorie remedies for recurrent herpes stomatitis in children.

From the initial stage of infection with herpetic stomatitis in children, it is necessary to adhere to the prescriptions of the sick child’s treatment plan, due to the fact that the virus is quite contagious, and therefore can easily spread actively and vigorously.

effectively treat the affected area of the oral cavity in accordance with the recommendations of the attending physician;
allocate separate household items and toys to a sick child;
strictly adhere to the rules of personal hygiene and oral care in order to avoid the addition of a bacterial infection;
Be sure to adhere to your diet and medication regimen;
consistently provide the child with a balanced diet and plenty of fluids;
It is not recommended to use heating agents.

Oral treatment

Treatment of the oral cavity can be done by rinsing decoctions of medicinal herbs, water-salt solution, medications prescribed by the attending physician.
For children who do not yet know how to rinse their mouth on their own, the oral cavity must be carefully irrigated by tilting the child’s head over a large container.
After rinsing the mucous membrane affected by herpetic stomatitis, it is necessary to treat both damaged and healthy areas with antiviral or analgesic, as well as wound-healing drugs. This is usually done using a cotton swab. It is necessary to carefully, very carefully, painlessly smear the affected areas.
For the formation of herpetic crusts and to prolong the action medications, it is necessary to make lotions and applications. Processes of treatment with analgesic drugs or herbal remedies relieve pain and inflammation.
And also at the healing stage, it is strongly recommended to additionally use sea buckthorn oil, oil solutions of vitamins A and E, to significantly accelerate healing.

To summarize, it is worth noting that herpetic stomatitis is very treatable complex treatment. Especially if treatment is started on time. Do not forget about treating wounds not only with rinsing, but also with lotions and applications. Well, for pharmacological treatment, we strongly do not recommend going to the pharmacy and selecting medications yourself or trusting the opinion of the pharmacy employee; it is better to show the child to the doctor.