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Oral diseases

Primary gingivostomatitis and herpetic whitlow

British Dental Journal volume 234, page 510 (2023)Cite this article

Primary herpetic gingivostomatitis is an acute infection of the oral cavity caused by the Herpes Simplex Virus. It is self-limiting and usually resolves itself in 10-14 days.1 Primary management includes reassurance, advice on symptom relief (paracetamol and/or ibuprofen), adequate fluid intake and optional antibacterial mouthwash to aid oral hygiene. It is also important to highlight the risk of transmission to other sites and other humans: no kissing and no nail biting!2 The patient was informed that once infected with HSV, it can be reactivated throughout life and present as herpes labialis.3 We also made the patient aware of the risk of infection spreading from the finger to the hand, causing viral cellulitis.4

At review, the patient had made a full recovery though he was a little lighter! This patient was prescribed multiple courses of antibiotics and passed from clinic to clinic without a formal diagnosis. This case report serves to remind clinicians of this grim condition but reassure them the strategy is simple and these patients will make a full recovery.

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References

  1. Heliotis I, Whatling R, Desai S, Visavadia M. Primary herpetic gingivostomatitis in children. BMJ 2021; doi: 10.1136/bmj-2021-065540.

  2. NICE. Scenario: Herpes labialis (cold sores) and gingivostomatitis. October 2021. Available at: https://cks.nice.org.uk/topics/herpes-simplex-oral/management/herpes-labialis-gingivostomatitis/ (accessed November 2022).

  3. Whitley R, Kimberlin D W, Prober C G. Pathogenesis and disease. In Arvin A, Campadelli-Fiume G, Mocarski E et al. (eds) Human herpesviruses: biology, therapy, and immunoprophylaxis. Cambridge: Cambridge University Press, 2007.

  4. Collier E, Parikh P, Martin-Blais R, Chen J, Anand V. Herpetic whitlow of the toe presenting with severe viral cellulitis. Pediatr Dermatol 2019; 36: 406-407.

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Authors and Affiliations

  1. University of Manchester Dental Hospital, Manchester, UK

    N. Amin & J. Darcey

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  1. N. Amin
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  2. J. Darcey
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Correspondence to N. Amin or J. Darcey.

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Amin, N., Darcey, J. Primary gingivostomatitis and herpetic whitlow. Br Dent J 234, 510 (2023). https://doi.org/10.1038/s41415-023-5744-6

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