viral lesions oral patho

8/3/2019 Viral Lesions Oral Patho

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VIRAL LESIONSVIRAL LESIONS


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1) HERPES GROUP :-

Herpes Simplex Herpes Zoster/ Variecella

Cytomegalic Virus

Epstein Barr- Virus- Infective Mononucleasis

a) Herpes Simplex

Consists prin. of the skin, Mucous membrane, eyes

& Central Nervous System.

TYPES:-

HSVI above the waist i.e. upper part of body.

Face, lips, oral cavity, etc. HSVII below the waist i.e. lower part of

body.

Genitals & Skin of lower body.

DNA VIRUS:-


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ORAL INFECTIONSORAL INFECTIONS

PRIMARYPRIMARY RECURENTRECURENTInfectionInfection InfectionInfection Without circulatingWithout circulating Circulating antibodiesCirculating antibodies

antibodiesantibodies are already present.are already present.


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1. Primary HS infection

Also k/a

* Acute Herpetic Gingivostomatitis.

* Herpetic Labialis* Fever Blisters

* Cold Sore

* Infectious Stomatitis

Most Common in older adults

Does Not affect the child below 6 months of age becauseof circulating antibodies.

SYMPTOMS:-

Regional lymphadenopathy, headache, malaise,

nausea, vomiting, pain upon swallowing.

SITE:- Lip, tongue, buccal mucosa, tonsils & pharynx may be

involved.

Oral Cavity becomes erythematous

Yellowish , fluid filled vesicles develop

Rupture

CLINICAL FEATURES :-


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Painful ulcers covered by a grey membrane and surrounded

by erythematous halo.

Vary 2- 6mm in size.

Heals spontaneously within 7 to 10 days.

No Scar

Usual Ganglion involved in HSV-I TRIGEMINAL

Usual Ganglion involved in HSV-II LUMBOSACRAL

HISTOPATHOLOGY

Intraepithelial blister and ballooning degeneration

Intranuclear inclusions LIPSCHUTZ BODIES.

2. Recurrent or Secondary Herpetic Infection:-

TYPES:

Recurrent herpes labialis (RHL)

Recurrent intraoral herpes simplex infection (RIM).

Occurs in a month to only about once a year.

CLINICAL FEATURES:-


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SYMPTOMS:-

Tingling & burning sensation & Feeling of tautness, swellingor slight soreness.

Size 1mm or less.

These gray or white vesicles rupture quickly leaving

small red ulcerations.

Ballooning degeneration, lipschutz bodies and Tzanck cells

are +nt.

B.) Varicella Zoster Infection :-

It is an acute disease caused by varicella zoster virus.

TYPES:-

Chicken box (Varicella) Shingles (herpes Zoster) or Zona

(1) Chicken Box:-

Also called varicella

H/F:-


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Age- children.

Commonly in winter and spring months.

Mode of transmission :- Air borne droplets or directcontact with infected lesions.

Incubation period - 2 weeks.

SYMPTOMS:- Headache,nasopharngitis,& anorexia followed by

maculopapular or vesicular eruptions on skin &

low grade fever.

Secondary infection:-

Pustules

healing

Small pitting scar

CLINICAL FEATURES:-


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Oral Manifestations:-

Involve the oral mucosa particularly buccal mucosa,

tongue, gingiva, palate.

Slightly raised vesicle with erythema.

HERPES ZOSTER:- SHINGLES, ZONA

FACTORS:-

Trauma Development of malignancy or tumor.

Local X-ray radiation.

Sex- Male = Female Prodromal period of 2-4 days.

SYMPTOMS:-

Shooting pain, parasthesia, burning & tenderness.

Hutchinsons Sign - Ocular involvement.

CLINICAL FEATURES:-


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Post herpetic neuralgia :- pain may continue for

weeks to months.

ORAL MANIFESTATION:-

Result from involvement of 2nd & 3rd div.of

trigemnal nerve.

It may be found on the Site buccal mucosa, tongue,

uvulva pharynx & larynx.

Associated with JAMES RAMSAY HUNTSYNDROME.

Hoarseness of voice, tinnitus, vertigo and vesicular

eruptions.

3.Cytomegalic Virus infections:-

SYMPTOMS:-

Hepatosplenomegaly,jaundice,petecheal

hemorrhage can also occur.

CLINICAL FEATURES:-


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Pneumonia, microcephaly, cerebral calcification andhearing.

ORAL MANIFESTATIONS:-

Patient may suffer from gingivitis & gingival

hyperplasia.

Oral Ulcers.

4. EPSTEIN-BARR VIRUS INFECTION:-

Seen in early adulthood

Often Characterized by a Syndrome k/a infetive

mononucleosis. Also with burkitts lymphoma & hairy leukoplakia.


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RNA VIRUS:-1.Paramixo virus:-

(i) Measles:- Also called, rubella/morbilli German Measles.

TRANSMISSION:-

Occurs by direct contact with a person or by droplet

infection & respiratory tract.CLINICAL FEATURES:-

Incubation period - 8 to 10 days.

SYMPTOMS:-

Fever, Malaise, cough, conjunctivitis, photophobia,

lacrimation & eruptive lesions of skin & oral mucosa.Sore throat.

Appears as tiny red macules or papules which

enlarge to form blotchy discolored irregular lesions.

O.M.

Kopliks spot


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PREVENTION:-

Active immunization: One injection of attenuated

measles is given in children over one year. Passive Immunization:- Human Immunoglobin given i.m.

under 18 months of age and debilitated children.

Dose : 250 Mg. for children under 1 year

500 mg. above this age.

(II) MUMPS:-

Site Major salivary glands but also affects testis,

meninges, pancreas, heart and mammary glands.

It is also called endemic parotitis.

Incubation period 2 to 3 weeks Age 5-15 Yrs.

Sex Male > Female

CLINICAL FEATURES:-


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SYMPTOMS:-

Headache, chills, moderate fever, vomiting, pain

below the ear.

1)HERPANGINA:-

Also called as Apthous pharyngitis & Vesicular

pharyngitis.

Age Young Children

3-10 years.

Incubation period 2 to 10 days

Symptoms Fever, chills, headache, anorexia,Prostration, abdominal pain & vomiting, sore throat,

dysphagia & sore mouth.

CLINICAL FEATURES:-


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SITE:-

Postr. pharynx, tonsil, facial pillars & soft palate.

Punctuate Macule

Papules & Vesicles

24 to 48 Hrs.

Ulcers ( 1 to 2 mm)

(Gray base & inflamed periphery)

Healing (1 week)

3. HAND FOOT AND MOUTH DISEASE :

Age 6 Months 5 Yrs.CLINICAL FEATURES:-


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SITE:-Hands, feet, legs & arms & buttocks.

SYMPTOMS:-

Anorexia, low-grade fever, lymphadenophathy, diarrhoea,

nausea & vomiting.

O.

M.

: The most common sites for oral lesions are hard palate, tongue

& buccal mucosa.

Vesicular & uncreative lesions.

Tongue becomes red and edematous.

3). TOGA VIRUS:-

Rubella Kopliks spot do not occur.

Oral Mucous membr. are not inflamed.


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Tonsils may be swollen & congested and red macules

may appear on palate.SYMPTOMS:-

Fever, Malaise & Headache.

HIV INFECTION:-1. Lesions strongly associated with HIV Infection.

* Candidiasis

* Hairy Leukoplakia

* Kaposis Sarcoma

* Non-Hodgkins Lymphoma

* Periodontal disease2. Lesions less commonly associated with HIV infection.

* Bacterial infections

* Melanotic hyperpigmentation

* Necrotising (ulcerative) stomatitis

CLINICAL FEATURES:-


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* Salivary gland disease

* Thrombocytopenic purpura

* Ulceration. NOS (not otherwise specified)

* Viral infections

3. Lesions rarely Seen in HIV Infection

* Bacterial infections

* Cat- scratch disease*Drug reactions (ulcerative), erythema multiforme,

behenoid, toxic epidermolysis)

* Fungal infection other than candidiasis

* Histoplasma Capsulatum

* Aspergilus flavus* Neurologic disturbances

* Recurrent apthous stomatitis

* Viral infections


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ACUTEHERPETIC GNIGIVOSTOMATITIS HERPES LABIALIS

RECURRENT HERPETIC INFECTION

HERPES SIMPLEX

VARICELLA

HERPES ZOSTER


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CYTOMEGALOVIRUS INFECTION HARPANGINA

Hand- Foot - & Mouth DiseaseRUBEOLA

MUMPS

HIV ASSOICATED CANDIDIASIS

HIV ASSOICATED GINGIVITISHIV ASSOICATED PERIODONTITIS


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HIV ASSOCIATED RECURRENTHERPETIC INFECTION

HIV ASSOCIATED HAIRY LEUKOPLAKIA

HIV ASSOCIATED KAPOSIs SARCOMAHERPETIC WHITLOW


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viral lesions oral patho

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