Herpes in the mouth is a herpes variant that affects mostly smaller children and rarely adults. It forms small blisters and mucosal damage in the mouth and throat are very painful. Read here the most important thing about herpes in the mouth.
Herpes in the mouth: description
Herpes in the mouth, also called stomatitis aphtosa, gingivostomatitis or mouth rot, occurs mainly in childhood. It is caused in most cases by herpes simplex virus type 1 (HSV1).
How is herpes in the mouth?
When first infected with the herpes simplex virus, the so-called primary infection, the virus enters superficial skin cells and multiplies there. Depending on where the herpes penetrates the body, the typical symptoms can occur in different places. Thus, herpes on the mouth as well as herpes in the nose is possible, even herpes on the hand, herpes on the hand or herpes on the leg occurs. Most common is herpes on the face.
For example, if the herpes spreads from the lip to the entire oral mucosa, it can lead to herpes in the throat, in extreme cases, even herpes in the throat.
How is herpes transmitted in the mouth?
The transmission of herpes in the mouth is usually by smear infection, ie by a direct transfer of viruses from one person to another person. This does not necessarily herpes in the mouth, but the much more common cold sores is the source of infection.
The viruses are mainly in the bladder fluid and distribute it in the saliva, which is a major risk factor in the transmission of herpes. The corner of the mouth and lips are the preferred entry sites for the viruses because the skin is relatively thin and has small cracks.
Transmission over the air is also possible over short distances – that is, via a droplet infection caused by saliva droplets that occur when sneezing or speaking. Children often have transmission of herpes. Fingers or hands are often afflicted with viruses, especially in children by scratching. When playing, close body contact is established, and then the viruses quickly pass from the hand of one child to the mouth of another.
Also, an indirect infection with cold sores on infected items is possible because the herpes virus outside of the body can survive up to two days. Therefore, used glasses, napkins or cutlery come as a source of infection into consideration.
In rare cases, an HSV2 infection can trigger a herpes in the mouth when the herpes simplex-2 viruses are transmitted from the genital area there. HSV2-induced herpes in the mouth is then contagious again in the same way as the HSV1-induced form.
When and how long is herpes contagious in the mouth?
An active herpes simplex disease is always contagious as long as the body excreted viruses. A risk of infection can exist shortly before the onset of the first symptoms and even a few days later and also depends on the so-called viral load. The more viruses that are excreted, the greater the transmission risk.
Who is affected by herpes in the mouth?
Herpes in the mouth affects almost exclusively small children, when they are infected for the first time with herpes simplex type 1. However, most infections are uncomplicated and without extensive involvement of the oral mucosa.
In adults, it is usually on the lip, sometimes on the nose to the typical symptoms of a herpes. Mouth and throat, however, are rarely affected – then often associated with a pronounced immunodeficiency.
Herpes in the mouth: symptoms and complications
Unlike ordinary herpes infection or simple reactivation, herpes in the mouth is often associated with severe discomfort. The mostly very young patients have a high level of suffering and often pain when eating and drinking. After infection, the symptoms usually occur over the course of a week.
Early symptoms of herpes in the mouth
Basically, first infections with herpes simplex are usually more severe than reactivations. Especially the so-called prodromal symptoms, ie those that occur before the actual onset of disease, are more pronounced when first infected with the virus. These include, for example, general signs of illness such as fever and chills, headache and body aches and fatigue.
Sometimes, the symptoms start a few days before the herpes breaks out, in other cases only hours before. Even during the herpes outbreak these symptoms often remain in addition.
Main symptoms of herpes in the mouth
The sufferers suffer from inflammation of the entire oral mucosa in this form of herpes. On the palate, the discomfort may occur as well as on the inside of the cheeks and in the throat area. Sometimes even symptoms of herpes on the tongue.
The affected areas in the mouth are initially painful and reddened, appear the typical for herpes, small bubbles, which are filled with a transparent or slightly cloudy liquid. If the bubbles burst, the mucous membrane is now open and temporarily damaged, so-called aphthae develop.
The anterior part of the mouth is usually most affected by herpes, including gums. In some cases, the lips are additionally affected, sometimes even shows herpes on the chin. In addition, the immediate lymph nodes on the lower jaw and neck often swell during the herpes outbreak. If the herpes extends into the cervical-pharyngeal area, there may also be dysphagia.
Complications of herpes in the mouth
The numerous aphthae are extremely painful for those affected by the herpes. Tongue, gums and oral mucosa are particularly sensitive to pain. Toddlers often refuse to eat or drink because of the pain, which can lead to additional complications and must be treated.
In the case of herpes in the throat and throat, the viruses can pass over the numerous blood vessels in this region directly into the systemic circulation and multiply throughout the body. This condition is called herpes sepsis and can be life threatening.
Herpes on the face
A majority of HSV1 outbreaks are variants of herpes on the face. There are particularly many sensory nerve fibers along which the herpes virus can move. So it comes not only in the mouth and on the lips, but sometimes also on the nose, cheek or forehead to herpes. The eye and ear – usually rarely affected – are critical sites of infection, as it can lead to visual and hearing disorders. Herpes in the nose (herpes nasalis) is after cold sores (herpes labialis) the most common variant in reactivating, but is usually harmless.
Another virus in the herpes family causes similar facial symptoms: varicella-zoster virus (VZV). It triggers in a first infection chickenpox, at later reactivation Herpes Zoster (shingles). The typical Blächen are similar to a herpes simplex infection, but do not occur in the mouth. herpes in the Ear or herpes on the nose, on the other hand, are typical localizations of a varicella zoster outbreak and are rarely affected in a herpes simplex disease.
Herpes in the mouth: diagnosis
The doctor usually suffices the so-called eye diagnosis to detect a herpes in the mouth. In order to exclude other diseases with similar symptoms or to determine the type of virus, further investigations may be used. A relatively simple procedure is the so-called Tzanck test. The doctor first makes a smear, usually from already burst bubbles and colors the examination material obtained with a dye. If the Tzanck test is positive, the examiner can observe so-called mononuclear or polynuclear giant cells under the light microscope, which are typical for a herpesic or varicella zoster infection.
In order to determine the type of virus, the viruses must either be cultivated or their genetic material must be duplicated and analyzed using a special procedure.
Herpes in the mouth: treatment
Medicines can reduce the duration and extent of symptoms when used early, but usually can not prevent an outbreak. Pain-relieving medicines are often used in small children to facilitate eating and drinking.
Herpes in the mouth: prognosis
Herpes in the mouth usually heals without treatment without consequences. With the healing of the aphthae after about a week, the pain goes back. There Herpes in the mouth usually occurs only in Erstinfektionen, a recurrence is unlikely. Even temporary defenses that lead to herpes reactivation, often only herpes in the nose or lip result.