Herpes Gingivostomatitis

Symptoms

Many small water blisters inside the mouth on the gums, tongue and lips. They quickly break open and become small mouth ulcers (sores)
The gums are very red and can bleed easily.
Ulcers also occur on the outer lips or skin around the mouth.
The ulcers occur equally on both sides of the mouth and lips.
The ulcers cause pain that interferes with feeding and swallowing. Poor fluid intake can lead to dehydration.
Lymph nodes in the neck are usually swollen and tender.
Fever present and may last 5 days.
Usually occurs age 1 to 3.

Cause

Herpes Simplex Virus type 1. The first infection with HSV1 can be severe
It usually follows contact with someone who has active cold sores (fever blisters). Often they have kissed the child.

Prevention of Spread to Others

Herpes virus is easily spread to other children who have not had it.
The virus is mainly found in the saliva and the sores.
Avoid sharing drinking glasses or eating utensils. Avoid kissing.
Also avoid sharing toys with other children. Reason: most young children put toys in their mouth.
The mouth sores are contagious for about 7 days.

Overview:

Liquid Antacid for Mouth Pain:

For mouth pain, use a liquid antacid such as Mylanta or the store brand. Give 4 times per day as needed. After meals often is a good time. Age: Use for children over 1 year old.
For children over age 6, can use 1 teaspoon (5 ml) as a mouth wash. Keep it on the ulcers as long as possible. Then can spit it out or swallow it.
For younger children age 1 to 6, put a few drops in the mouth. Can also put it on with a cotton swab.
Caution: Do not use regular mouth washes, because they sting.

Avoid Numbing Medicines:

Pain Medicine:

To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.

Fever:

For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.

Anti-Viral Drug by Mouth:

Oral anti-viral medicine can help the sores go away faster if started early. That usually means within 3 days of when the infection started.
If your doctor has prescribed an anti-viral drug, take it as advised.
Try not to forget any of the doses.

Antibiotics Not Needed:

Fluids and Soft Diet:

Try to get your child to drink adequate fluids.
Goal: keep your child well hydrated.
Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is more important than eating any solids.
For babies, offer fluids in a cup, spoon or syringe rather than a bottle. Reason: The nipple may increase pain.

What to Expect:

Return to Child Care or School:

Older children can return to school after the fever is gone.
Younger children who can't stop touching their mouth need to stay home for 7 days.
Also, they need to avoid sharing toys with other kids for a week.

Definition