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Stomatitis is an inflammation of the oral mucosa that may extend to the buccal mucosa, lips, and palate. It’s a common infection that may occur alone or as part of a systemic disease. There are two main types: acute herpetic stomatitis and aphthous stomatitis. Acute herpetic stomatitis is usually self-limiting; however, it may be severe and, in neonates, may be generalized and potentially fatal. Aphthous stomatitis usually heals spontaneously, without a scar, in 10 to 14 days. Other oral infections include gingivitis, periodontitis, and Vincent’s angina. (See Types of oral infections, page 688.)
Acute herpetic stomatitis results from the herpes simplex virus. It’s common in children ages 1 to 3. The cause of aphthous stomatitis is unknown, but predisposing factors include stress, fatigue, anxiety, febrile states, trauma, and solar overexposure. This type is common in girls and female adolescents.
Acute herpetic stomatitis begins suddenly with mouth pain, malaise, lethargy, anorexia, irritability, and fever, which may persist for 1 to 2 weeks. Gums are swollen and bleed easily, and the mucous membrane is extremely tender.
Papulovesicular ulcers appear in the mouth and throat and eventually become punched-out lesions with reddened areolae. Submaxillary lymphadenitis is common. Pain usually disappears 2 to 4 days before healing of ulcers is complete. If the child with stomatitis sucks his thumb, these lesions spread to the hand.
A patient with aphthous stomatitis typically reports burning, tingling, and slight swelling of the mucous membrane. Single or multiple shallow ulcers with whitish centers and red borders appear and heal at one site and then reappear at another. (See Looking at aphthous stomatitis.)
Diagnosis is based on the physical examination; in Vincent’s angina, a smear of ulcer exudate allows for identification of the causative organism.
For acute herpetic stomatitis, treatment is conservative. For local symptoms, supportive measures include warm salt-water mouth rinses (antiseptic mouthwashes are contraindicated because they are irritating) and a topical anesthetic to relieve mouth ulcer pain. Topical antihistamines, antacids, or corticosteroids may also be recommended. Supplementary treatment includes a bland or liquid diet and, in severe cases, I.V. fluids and bed rest.
For aphthous stomatitis, primary treatment is application of a topical anesthetic. Effective long-term treatment requires alleviation or prevention of precipitating factors.
Read excerpts from these other book chapters related to Tongue rash:
Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2008 Williams & Wilkins.
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More About This Book:
Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X 
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