Oral cavity & oropharynx
Herpes simplex virus

Topic Completed: 1 August 2012

Minor changes: 12 October 2020

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PubMed Search: Herpes simplex virus[TI] oral[TI] full text[sb]

Patricia DeVilliers D.D.S., M.S.
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Cite this page: DeVilliers P Herpes simplex virus. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityHSV.html. Accessed April 18th, 2021.
Definition / general
  • Also called cold sore
  • Usually HSV1
  • Lasts 3 - 4 weeks, then virus tracks along regional nerves and becomes dormant in trigeminal or other local ganglia
  • Most infected adults have latent HSV1 that is activated by upper respiratory infection, excessive exposure to cold, wind, sun, allergies

Acute herpetic gingivostomatitis:
  • Rare, children 2 - 4 years with diffuse involvement of oral and pharyngeal mucosa, tongue, gingiva
  • Fiery red mucosa and swelling with clusters of vesicles

Recurrent herpetic stomatitis:
  • Groups of 1 - 3 mm vesicles on the lips, nasal orifices, buccal mucosa
  • Lesions heal in 7 - 10 days

Tzanck test: microscopic examination of vesicle fluid shows giant cells, inclusions
Gross description
  • Vesicles or bullae with clear serous fluid, painful shallow ulcers
Microscopic (histologic) description
  • Intra and intercellular edema (acantholysis), intranuclear inclusions, multinucleate polykaryons (giant cells)
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