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Herpetic Stomatitis : Causes, Signs, Symptoms, Diagnosis, Treatment, Prevention

Herpetic stomatitis is a viral infection affecting the mouth, which results in inflammation and formation of ulcers. These oral ulcers are different from canker sores in that they are caused by different viruses. Also, canker sores are not contagious, whereas herpetic stomatitis is.

Herpetic Stomatitis

Causes of Herpetic Stomatitis

Herpes simplex virus or HSV-1 is the cause behind herpetic stomatitis. This condition is commonly seen in young children and is usually the child’s initial exposure to the herpes virus. Any break or injury in the skin allows this virus to enter the body. Skin or physical contact with an infected person transmits this infection. Any adult of the child’s family could have a cold sore when the child develops herpetic stomatitis.

Signs and Symptoms of Herpetic Stomatitis

  • High fever before the appearance of blisters/ulcers.
  • Tingling sensation in the site of blisters before their appearance.
  • Blisters develop in the mouth, commonly on the tongue, palate, cheeks, gums, throat and the margin of the lips.
  • Dysphagia (difficulty swallowing) with difficulty in eating and drinking.
  • Drooling.
  • Patient feels irritable all the time.
  • Patient experiences pain and dryness in the mouth.
  • There may be swelling, reddening or bleeding of the gums.
  • After the blisters have burst, ulcers form in the mouth, commonly on the tongue and cheeks.
  • Patient experiences muscle aches.
  • The lymph nodes in the neck may become swollen and painful.
  • There is also decrease in the urine output.
  • The most contagious period is from the time of the rupture of the blisters till their complete healing.

Investigations for Herpetic Stomatitis

  • Examination of the mouth sores is usually sufficient for diagnosis.
  • Further tests, such as a sample of the tissue and fluid from the ulcers, can be sent for testing and culture can be done to confirm the diagnosis.
  • Tzanck smear is a staining test, which reveals the nonspecific changes in the cell nucleus occurring from HSV.
  • Antigen and antibody testing can be done to find out if the infection is caused by HSV-1 or HSV- 2.

Treatment for Herpetic Stomatitis

Treatment Comprises Of:

  • Mild infection usually requires no treatment.
  • Oral antiviral medicines, such as acyclovir and famciclovir, are prescribed for severe infections.
  • Topical antivirals can also be used.
  • Local anesthetics, such as viscous lidocaine, can be applied to the mouth for pain relief. However, caution should be exercised when using it as it numbs all the sensation and patient may find difficulty in swallowing, which could lead to choking.
  • Medicines, such as NSAIDs (ibuprofen, naproxen) and acetaminophen (Tylenol), can be given for fever and muscle aches.
  • Hospitalization may be needed for severe cases where the patient is dehydrated, has a weak immune system, for infants and if the infection has spread to other organs.
  • Patient is advised a liquid diet comprising of non-acidic, cold/cool drinks.
  • It takes around a week to completely recover from Herpetic Stomatitis.

Prevention of Herpetic Stomatitis

  • Adults having active cold sores should avoid close contact with children, such as hugging or kissing them.
  • Parents should keep their children away from other kids who are having this infection and not share things like glasses, utensils, toys, food etc.


  1. MedlinePlus. (2021). Herpetic stomatitis. https://medlineplus.gov/ency/article/000606.htm
  2. NHS. (2019). Cold sores. https://www.nhs.uk/conditions/cold-sores/
  3. Centers for Disease Control and Prevention. (2020). Genital Herpes – CDC Fact Sheet (Detailed). https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm
Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:September 6, 2023

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