Herpes simplex virus infection, with particular reference to the progression and complications of primary herpetic gingivostomatitis

Abstract

Primary herpetic gingivostomatitis (PHGS) represents the clinically apparent pattern of primary herpes simplex virus (HSV) infection, since the vast majority of other primary infections are symptomless. PHGS is caused predominantly by HSV-1 and affects mainly children. Prodromal symptoms, such as fever, anorexia, irritability, malaise and headache, may occur in advance of disease. The disease presents as numerous pin-head vesicles, which rupture rapidly to form painful irregular ulcerations covered by yellow-grey membranes. Sub-mandibular lymphadenitis, halitosis and refusal to drink are usual concomitant findings. Following resolution of the lesions, the virus travels through the nerve endings to the nerve cells serving the affected area, whereupon it enters a latent state. When the host becomes stressed, the virus replicates and migrates in skin, mucosae and, in rare instances, the central nervous system. A range of morbidities, or even mortality, may then occur, i.e., recurrent HSV infections, which are directly or indirectly associated with PHGS. These pathological entities range from the innocuous herpes labialis to life-threatening meningoencephalitis.

The Herpes Simplex Virus Type 1 BgKLVariant, Unlike the BgOLVariant, Shows a Higher Association with Orolabial Infection than with Infections at Other Sites, Supporting the Variant-Dispersion-Replacement Hypothesis

“…Third, primary HSV-1 infections usually occur in young children in Japan (21,44), and the mouth and lips are the most commonly infected sites, with gingivostomatitis being the main manifestation (2,3,16,39). Primary infection in young adults is often detected as pharyngitis (12,35,39).…”

Fatal Human herpesvirus 1 (HHV-1) infection in captive marmosets (Callithrix jacchus and Callithrix penicillata) in Brazil: clinical and pathological characterization

“…Humans are the original host and reservoir with either typical symptoms of acute gingivostomatitis or asymptomatic infection (Roizman et al 2007). HHV-1 is spread by direct contact with infected secretions, usually from orolabial vesicles ('cold sores') (Kolokotronis & Doumas 2006). After local replication, the virus is conveyed by retrograde axonal transport along sensory fibers to the trigeminal ganglion, where, after further replication, latent infection is established (Roizman et al 2007).…”

“…The possible outcomes of viral reactivation are: asymptomatic stage, development of cold sores or viral encephalitis (Kolokotronis & Doumas 2006, Roizman et al 2007.…”

Acyclovir Crystalluria: A Rare Secondary Effect of a Common Drug

“…Herpetic gingivostomatitis is one of the most common forms of primary herpes simplex virus infection during childhood [4]. It is characterized by gingival edema and erythema and very painful mouth ulcers, and it is accompanied by general symptoms such as fever or anorexia.…”