Stomatitis - herpetic; Primary herpetic gingivostomatitis
Herpetic stomatitis is an infection caused by the herpes simplex virus (HSV), or oral herpes. Young children commonly get it when they are first exposed to HSV. The first outbreak is usually the most severe. HSV can easily be spread from one child to another.
If you or another adult in the family has a cold sore, it could have spread to your child and caused herpetic stomatitis. More likely, you won't know how your child became infected.
Herpetic stomatitis is a viral infection of the mouth that causes sores and ulcers. These mouth ulcers are not the same as canker sores, which are not caused by a virus.
Your child's health care provider can most often diagnose this condition by looking at your child's mouth sores.
Sometimes, special laboratory tests can help confirm the diagnosis.
Your child should recover completely within 10 days without medical treatment. Acyclovir may speed up your child's recovery.
Your child will have the herpes virus for life. In most people, the virus stays inactive in their body. If the virus wakes up again, it most often causes a cold sore on the mouth. Sometimes, it can affect the inside of the mouth, but it won't be as severe as the first episode.
About 90% of the population carries HSV. There's little you can do to prevent your child from picking up the virus sometime during childhood.
Your child should avoid all close contact with people who have cold sores. So if you get a cold sore, explain why you can't kiss your child until the sore is gone. Your child should also avoid other children with herpetic stomatitis.
If your child has herpetic stomatitis, avoid spreading the virus to other children. While your child has symptoms:
Symptoms may include:
Symptoms may be so uncomfortable that your child doesn't want to eat or drink.
Your child's provider may prescribe:
Use lidocaine with care, because it can numb all feeling in your child's mouth. This can make it hard for your child to swallow, and may lead to burns in the mouth or throat from eating hot foods, or cause choking.
There are several things you can do at home to help your child feel better:
Call your provider if your child develops a fever followed by a sore mouth, and your child stops eating and drinking. Your child can quickly become dehydrated.
If the herpes infection spreads to the eye, it is an emergency and can lead to blindness. Call your doctor right away.
Kimberlin DW, Prober CG. Herpes simplex virus. In: Long SS, Prober CG, Fischer M, eds. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 204.
Martin B, Baumhardt H, D'Alesio A, Woods K. Oral disorders. In: Zitelli, BJ, McIntire SC, Nowalk AJ, eds. Zitelli and Davis' Atlas of Pediatric Diagnosis. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 21.
Tinanoff N. Common lesions of the oral soft tissues. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 315.
Review Date: 9/5/2017
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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