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Family Medicine (Expert Forum)
fever blisters, canker sores, cold sores ????
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
fever blisters, canker sores, cold sores ????
by joannie1971, Apr 08, 2004 12:00AM
I have a 4yr daughter. On 4/2/04 she started w/ fever of around 101.5 and vomiting. Sat took her to er was diag w/ ear infection and strep. Mon took her to dr office was told er was wrong she had fever blisters in mouth. Walked into dr office again on wed w/ child screaming in pain and made dr take another look. Now I am told she has a herpes outbreak in her mouth and down her throat. She is still running the same fever and her mouth is like nothing I have seen. She has at least 2 blisters or sores on her bottom lip outside. She has 5-6 sores along the upper gum line and top lip and 4 on the bottom gum line and lip. Her tongue has swollen and turned white except for the spots that are raw and red. She is in constant pain and so far it has only gotten worse. She was on amooxil from sat to mon, we where told to use ambosol or oral gel. Also I made a homemde wash of maalox, benedril and water. Tuesday after begging for something to help her they gave us tylenol w/ codedine. Wed they stopped everything and gave us zovirax and a mouth wash of ben/maal and lidocane. She screams and is in so much pain with this mouth wash she shakes when we apply. And thru this all we have been giving mortin for the fever. I am hoping that her mouth is just so raw that this medicne is really helping but here I am at 4:30 am because I am scared and don't know if this is the right thing for my daughter. Is this anything anyone has ever heard of and in someone's opinion are we on the right road now? How does a child get this? No one in our family has had a cold sore or even been ill recently. She does go to daycare. How long should this last. The only answer I can get out of any doctor I have seen is whenever the sores crust over. But what does that mean, 5 days 2 wks what? If there is anything left out or unclear maybe I can clearify thank you for any help Joan Hancock
Doctor's Answer
by Kevin Pho, MD, Apr 08, 2004 12:00AM
, Apr 08, 2004 12:00AM
Primary herpes simplex virus (HSV) infection occurs in young children approximately one week after contact with an infected child or adult.
Signs of oral infection include red, edematous marginal gingivae that bleed easily, and clusters of small vesicles that become yellow after rupture and are surrounded by a red halo. The vesicles coalesce to form large, painful ulcers of the oral and perioral tissues. The oral lesions are accompanied by fever, arthralgia (joint pain), headache, and enlarged lymph nodes.
The lesions typically resolve spontaneously within two weeks and do not scar. Fluid intake (including ice and popsicles) must be encouraged. There are some oral analgesics (such as Zilactin or Abreve) that can be discussed with your personal physician. In more severe cases, oral narcotics, usually in the form of elixirs, may be required for adequate pain relief. Antiseptics may hasten drying of lesions and decrease the risk of superinfection.
The Zovirax has been shown to shorten to duration of infection in some cases. If pain continues to be an issue, then another opinion can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Delaney et al. Soft tissue lesions of the oral cavity in children. UptoDate, 2004.
Signs of oral infection include red, edematous marginal gingivae that bleed easily, and clusters of small vesicles that become yellow after rupture and are surrounded by a red halo. The vesicles coalesce to form large, painful ulcers of the oral and perioral tissues. The oral lesions are accompanied by fever, arthralgia (joint pain), headache, and enlarged lymph nodes.
The lesions typically resolve spontaneously within two weeks and do not scar. Fluid intake (including ice and popsicles) must be encouraged. There are some oral analgesics (such as Zilactin or Abreve) that can be discussed with your personal physician. In more severe cases, oral narcotics, usually in the form of elixirs, may be required for adequate pain relief. Antiseptics may hasten drying of lesions and decrease the risk of superinfection.
The Zovirax has been shown to shorten to duration of infection in some cases. If pain continues to be an issue, then another opinion can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Delaney et al. Soft tissue lesions of the oral cavity in children. UptoDate, 2004.
Member Comments (2)
by ozark, Apr 08, 2004 12:00AM
look up coxsackie also called foot and mouth disease caused by the herpes virus...youmay get more info re this....if she doesnt drink well and continues with a fever she may need to get iv hydration....unfortunately it takes time and patience before it gets better.....try the popsicles and jello, ice cream ...when its down their throat it is very uncomfortable,,,maybe you could try rectal tylenol to see if it helps.good luck
by alexandria, Apr 09, 2004 12:00AM
Ask your doctor if your daughter has developed impetago. I developed this after exposure to the sun and developed cold sores on my mouth and in my throat as well as on the face and chin. I developed swollen glands and also had a high fever as a result.It took 2-4 weeks to resolve completely. As I recall, I was given some antibiotic (probably a penicillin) and was told to wash the area with physoderm (OTC). I think I recall also gargling with a mixture of some sort to reduce the bacteria. I was also misdiagnosed in the beginning which allowed the bacteria to spread. This sounds very familiar although I've never heard of it with a very young child. Always worth asking about, though.
