Manifestations of infectious diseases in the oral cavity

Herpetic gingivostomatitis (gingivostomatitis herpetica)
Herpetic gingivostomatitis is an enanthema disease of the tongue, gums and palate with small painful vesicles and ulcers and reddened mucosa. It is a manifestation of primary infection with herpes simplex virus, it occurs mainly in infants and toddlers. The pain does not allow the child to drink; the child is more salivating.

Differential diagnosis

 * aphthous stomatitis caused by other viruses
 * herpangina (Coxsackie A, B) - sore throat, whitish vesicles on the soft palate, uvula and tonsils, no gums affected, occurring in older children and adolescents, rather in the summer months
 * hand-foot-mouth syndrome (Coxsackie A)
 * aphthae epizooticae
 * aphthous and ulcerative manifestations in HIV-infected patients
 * primary syphilis
 * recurrent aphthae of various etiologies (carious teeth, dietary damage - nuts, rose hips)
 * Bednář's aphids of newborns
 * Stevens-Johnson syndrome
 * Behçet syndrome
 * pemphigus vulgaris

Palate

 * scarlatina (Scarlet fever), rubeola (rubella), morbilli (measles) - enanthema or petechiae
 * mononucleosis infectiosa (petechiae = Holzel's sign)

Tonsils

 * scarlatina (Scarlet fever, catarrhal to lacunar angina)
 * mononucleosis infectiosa (coating angina)
 * enterovirus rash (aphthae and ulceration in herpangina)

Buccal mucosa

 * morbilli (measles) - Koplik's stains
 * varicella

Tongue

 * scarlatina (Scarlet fever) - raspberry tongue = lingua scarlatinosa
 * varicella

Lips

 * scarlatina, Kawasaki syndrome - deep red
 * morbilli (measles) - deep red

Infection

 * fungal: Candida albicans and non-albicans species (soor, stomatitis angularis), Histoplasma capsulatum, Cryptococcus neoformans
 * viruses: EBV (hairy leukoplakia), HSV (orální herpes simplex), VZV (orofaciální herpes zoster), CMV (ulcerace)
 * bakterie: Treponema pallidum (syphilis primaria)

Tumory

 * Kaposiho sarkom
 * non-hodgkinský lymfom

Jiná onemocnění

 * aftózní stomatitida
 * primární HIV ulcerace
 * HIV gingivitida
 * ulcerózní HIV gingivitida
 * HIV periodontitida
 * nekrotizující stomatitida

Epidemická parotitida (parotitis epidemica)
Diferenciální diagnóza:
 * hnisavá parotitida, resp. sialoadenitida
 * sialolitiáza
 * recidivující aseptická parotitida
 * parotitidy vyvolané herpetickými viry (CMV) nebo enteroviry (Coxsackie A)
 * parotidomegalie HIV pozitivních dětí
 * toxické parotidomegalie vyvolané vzácně otravami těžkými kovy (Hg, Pb)
 * tumorózní zduření žlázy (hemangiom, lymfosarkom apod.)
 * Mikuliczův syndrom (leukemie)
 * Sjögrenův syndrom
 * metabolická sialopatie při diabetu (Charvátův příznak)