Acute Herpetic (Aphthous) Stomatitis

What is Acute Herpetic (Aphthous) Stomatitis?

Acute herpetic (aphthous) stomatitis is an acute contagious infectious disease that occurs with symptoms of general toxicosis of the body and local lesions of the oral mucosa. At the same time, there are violations on the part of the immunological system, the absence or inhibition of specific and nonspecific immunity factors. Herpes infection should be considered as a serious disease that occurs in violation of the immune, reticuloendothelial and nervous systems.

Causes of Acute Herpetic (Aphthous) Stomatitis

The causative agent of acute herpetic stomatitis is herpes simplex virus (HSV).

By antigenic properties of the virus is divided into 2 types. Type 1 – herpetic lesions on the oral mucosa, type 2 – lesion of the genital organs. The virus is DNA-containing. In the body, it multiplies in epithelial cells. Having entered the child’s body and causing manifestations of a primary herpetic infection, it remains in the latent state of a person’s life or causes a relapse of the disease (recurrent herpetic stomatitis). The virus is found in 75-90% of the adult population. Primary infection occurs more often at the age of 1-3 years, when the amount of antibodies received from the mother in the child’s blood disappears or decreases, and the body becomes susceptible to infection with the virus.

Pathogenesis during Acute Herpetic (Aphthous) Stomatitis

The source of infection is a sick person or a virus carrier (close relatives, attendants, children with acute herpetic stomatitis and recurrent herpetic stomatitis).

Cases of 6–10-month-old infants artificially fed from the first months of life have become more frequent. The disease is severe in newborns, especially contagious for people not previously infected with the virus.

Thus, studies indicate a relatively high incidence of acute herpetic stomatitis among children. The results confirm the data on the delay in recovery of the immunological reactivity of the organism in acute herpetic stomatitis from the time of clinical recovery.

The analysis showed that among patients there is a high percentage with moderate and severe forms of acute herpetic stomatitis, with long-term illness. Therefore, the treatment of acute herpetic stomatitis should be reduced not only to the treatment of stomatitis, but also the whole body with the participation of many specialists (pediatrician, dentist, immunologist, neuropathologist, etc.). Radical treatment should be directed not only at the epithelization of the elements of the lesion on the oral mucosa, but mainly at normalizing the indices of nonspecific immunity, restoring the body’s defenses.

Children suffering from acute herpetic stomatitis, especially moderate and severe form, are subject to constant monitoring by a pediatrician.

After the virus enters the body of the child, its reproduction occurs in the cells of local tissues and the nearest lymphatic formations; therefore, the appearance of lesion elements in the oral cavity is preceded by lymphadenitis of varying severity. The submandibular lymph nodes are usually involved in the process and accompany the course of the disease. In the incubation period, primary viraemia is observed, i.e. penetration of the virus into the bloodstream. Penetrating through the capillary barrier by diapedesis, the HSV is deposited in the liver, spleen and other organs and multiplies rapidly. There are lesions of tissues by type of foci of necrosis.