Pediatric emergency medicine trisk 1019 1019
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prompt consideration of immune status, as it is more common in patients with
human immunodeficiency virus (HIV) or other immunosuppressed states. Fungal
infection may also present as a well-circumscribed area of papillary atrophy in the
central tongue, termed median rhomboid glossitis. It is generally asymptomatic,
but often responds to antifungals if necessary.
Primary infection with the herpes simplex virus (HSV), especially type 1
(HSV-1) commonly presents in young children or infants as herpes
gingivostomatitis. It causes painful vesicles, erosions, ulcerations, and erythema
on the gingiva, mucosa, and perioral tissue, often with fever, poor oral intake, and
drooling. Recurrent disease manifests as herpes labialis or “cold sores,” painful
vesicular lesions on or around the lips. Lesions may be triggered by acute febrile
illnesses, sun exposure, or stress.
