Viral Infections

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Primary Herpetic Stomatitis

Description

Causative agent is Herpes Simplex Virus 1 (HSV 1).

Signs and Symptoms

  • Multiple oral ulcers
  • Fever
  • Malaise
  • Anorexia and irritability
  • In children, they may have drooling of saliva

Treatment

  • For symptomatic relief; soft diet and adequate fluid intake, since this is a self-limiting illness
  • Antipyretic such as paracetamol 125mg to 500mg 8 hourly for 3-5 days
  • Local antiseptic mouthwashes such as chlorhexidine 2% solution
  • Acyclovir, 10mg/kg 8 hourly orally for 7-10 days

Herpes simplex labialis (cold sore)

Description

Causative agent is HSV 1. The virus is latent in the trigeminal ganglia and is reactivated as herpes labialis. It is precipitated by sunlight, trauma, systemic disease or stress.

Signs and Symptoms

Papules are followed by blisters then pustules crusting.

Treatment

Acyclovir cream (5%) applied 6 hourly early, before blisters appear

Herpes zoster (shingles)

Description

Causative agent is Varicella Zoster Virus (VZV) (causative organism for chicken pox).

Signs and Symptoms

It presents as an acute painful, vesicular rash along the dermatomal distribution of the sensory nerves; commonly of the trigeminal branches (mandibular and maxillary).

Treatment

  • Acyclovir 800mg oral 5 times daily

OR

  • Valaciclovir 1g oral, 8 hourly for 7 days; beneficial only if started within 72 hours from the onset of the

vesicles.

AND

  • Paracetamol 1g 8 hourly for 5 days

OR

  • Diclofenac (PO) 50mg- 100mg 8 hourly for 5 days

OR

  • Ibuprofen (PO) 400mg 8 hourly for 5 days