A child with fever of 102 degrees F and vesicles in the oral cavity is probably suffering from:

 # A child with fever of 102 degrees F and vesicles in the oral cavity is probably suffering from:
A. Herpes Simplex type I
B. Juvenile periodontitis
C. Acute herpetic gingivostomatitis
D. Neutropenia

The correct answer is C. Acute Herpetic Gingivostomatitis.

In some preschool children the primary infection of Herpes Simplex virus may be characterized by only one or two mild sores on the oral mucous membranes, which may be of little concern to the child or may go unnoticed by the parents. In other children the primary infection may be manifested by acute symptoms (acute herpetic gingivostomatitis). The active symptoms of the acute disease can occur in children with clean mouths and healthy oral tissues. The symptoms of the disease develop suddenly and include, in addition to the fiery red gingival tissues, malaise, irritability, headache, and pain associated with the intake of food and liquids of acidic content. A characteristic oral finding in the acute primary disease is the presence of yellow or white liquid-filled vesicles. In a few days the vesicles rupture and form painful ulcers, 1 to 3 mm in diameter, which are covered with a whitish gray membrane and have a circumscribed area of inflammation. The ulcers may be observed on any area of the mucous membrane, including buccal mucosa, tongue, lips, hard and soft palate, and the tonsillar areas. Large ulcerated lesions may occasionally be observed on the palate or gingival tissues or in the region of the mucobuccal fold. This distribution makes the differential diagnosis more difficult. An additional diagnostic criterion is a fourfold rise of serum antibodies to HSV-1. The lesion culture also shows positive results for HSV-1.


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