Stomatitis

Introduction to stomatitis Stomatitis is inflammation of the oral mucosa, which can affect the buccal mucosa, tongue, gums, upper jaw and so on. It is more common in children, especially infants and young children, but it can be secondary to diarrhea, malnutrition, acute infection, chronic illness and other systemic diseases. The main causes of stomatitis are bacteria, viruses and fungi, which are induced by wound infection or decreased systemic resistance. Bacterial infectious stomatitis often uses streptococcus and staphylococcus as the main pathogens. These bacteria in the case of acute infection, long-term diarrhea and other low body resistance, if the mouth is not clean, the bacteria cause massive proliferation, resulting in acute oral mucosal damage. If it is a long-term diarrhea and repeated episodes of aphthous, mostly spleen weakness, can be used to participate in the sputum atractylodes sinensis. Heart and kidney yin deficiency mouth sore can be treated with Liu Wei Di Huang Wan combined with heart pills. In the late stage of fever, heat evil smoldering yin, Yin liquid loss; virtual fire caused by inflammation, can be treated with Yangyin Qingfei Decoction (shengdi, Ophiopogon japonicus, Scrophulariaceae, Fritillaria, Danpi, Baiji, etc.). basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: Chronic pharyngitis Constipation Headache Nausea and vomiting

Cause of stomatitis

Bacterial infection (45%)

Bacterial infectious stomatitis often uses streptococcus and staphylococcus as the main pathogens. These bacteria in the case of acute infection, long-term diarrhea and other low body resistance, if the mouth is not clean, the bacteria cause massive proliferation, resulting in acute oral mucosal damage.

Virus infection (35%)

The causative agent of herpetic stomatitis is herpes simplex virus. A local rash appears in the skin and rapidly oozes out to form blisters. At the beginning, the oral mucosa is congested and edematous, followed by erosions or ulcers of varying sizes, with a grayish white pseudomembrane formed by thicker fibrous inflammatory exudates.

Stomatitis prevention

1, pay attention to oral hygiene, to avoid damage to the oral mucosa, to avoid spicy food and local irritation.

2, to maintain a comfortable, optimistic and cheerful, to avoid things and anxious.

3. Ensure adequate sleep time and avoid excessive fatigue.

4, pay attention to the regularity of life and nutritional balance, develop a certain bowel habit, prevent constipation.

Stomatitis complications Complications Chronic pharyngitis constipation headache nausea and vomiting

Bad breath, red and swollen gums, chapped lips, chronic pharyngitis, constipation, headache, dizziness, nausea, fatigue, irritability, fever, swollen lymph nodes.

Oral inflammation symptoms Common symptoms Oral mucosa leukoplakia Oral mucosa soy beans... Oral mucosal ulcers Oral mucosa shedding abnormal taste fever

1, clinical manifestations of ulcerative stomatitis

It can occur in all parts of the mouth, usually in the lips, tongue and buccal mucosa, and can spread to the lips and throat. Initial mucosal congestion, edema, may have herpes, after the occurrence of erosion or ulcer of varying sizes, the wound covered with thicker fibrous exudate formed gray-white or yellow pseudo-membrane, the boundary is clear, easy to wipe, residual blood after rubbing The smashed noodles soon reappeared. Local pain, swollen lymph nodes. Anti-feeding, irritability, fever 39 ° C ~ 40 ° C. The white blood cells in the peripheral blood are often increased, and a large number of bacteria can be seen in the effusion of the wound exudate. The body temperature is light for about a week, the body temperature returns to normal, the ulcer gradually heals, and severe dehydration and acidosis can occur.

2, herpes stomatitis clinical manifestations

Onset, the fever reached 38 ° C ~ 40 ° C, after 1 ~ 2 days, the oral mucosa of the gums, lips, tongue, buccal mucosa and other parts of the oral mucosa appeared a single or cluster of small herpes, diameter 2 ~ 3mm, surrounded by red halo, quickly broken After ulceration, ulcers are formed, covered with yellow-white cellulose secretions, and multiple ulcers can be fused into irregular large ulcers, sometimes involving the upper jaw and the pharynx. Sore rash often occurs in the skin of the mouth and lips. The pain is quite severe, refusal to eat, runny, irritated, and the submandibular lymph nodes often enlarge. The body temperature returned to normal after 3 to 5 days, and the course of disease was about 1 to 2 weeks. Local lymphadenopathy can last for 2 to 3 weeks.

3, the clinical manifestations of drug allergic stomatitis

Drug allergic stomatitis refers to the acute inflammation of the oral mucosa after taking a certain drug. It usually takes about 24 hours after taking the drug. The early symptoms are congestion of the oral mucosa, edema or erythema and blisters. As the drug continues to absorb, the early symptoms gradually worsen and form mucosal ulceration. This kind of mucosal ulceration surface is different from the general aphthous appearance, covering the bloody secretion on the ulceration surface, swelling of the ulcer surface, often causing irritating severe pain, and the child refuses to eat due to pain. The area of drug allergy is more common in the front of the mouth, such as the lower lip mucosa, the back of the tongue, the upper jaw and so on.

4, clinical manifestations of Candida keratitis

Candidal angular cheilitis The disease is often characterized by bilateral irritation. The skin and mucous membranes in the mouth area are cleft, the adjacent skin and mucous membranes are congested, and the cleft palate often has erosions and exudates, or thin Hey, he has pain or hemorrhage when opening his mouth. Such moldy angular keratitis characterized by wet white erosion should be distinguished from vitamin B2 deficiency or bacterial angular keratitis. The former is accompanied by glossitis, cheilitis, scrotum or vulvitis, and the latter is more common in one side of the mouth. Bacterial culture is positive (mainly by streptococcus), while Candida keratitis occurs mostly in children, debilitated patients and patients with blood diseases.

The keratitis of the elderly patients is mostly related to the shortening of the vertical distance of the occlusion. The skin in the mouth area collapses and is grooved, which causes the saliva to overflow from the mouth into the groove, so it is often in a damp state, which is conducive to mold growth and reproduction. 150 cases of dentures have been reported, and 75 cases of angular keratitis. The cause of this is in addition to the reduction of vertical distance and some systemic factors. It is also closely related to the local stimulation of dentures and the infection of denture ulcers.

Stomatitis check

Blood routine examination

Bacterial stomatitis increased the total number of white blood cells, and the number of white blood cells in herpetic stomatitis was normal.

2. Histopathological examination

The basal tissue of the blister was stained, and multinucleated giant cells were observed. Eosinophil particles were found in the nucleus. Under the electron microscope, the herpes simplex virus was found to be second only to the center of the nucleus.

Diagnosis of stomatitis

diagnosis

1. History: Bacterial stomatitis often has a history of acute infection before onset, and herpetic stomatitis may have a history of exposure to this disease.

2. Clinical manifestations: See the above clinical manifestations.

3. Blood routine examination: the total number of white blood cells in bacterial stomatitis is increased, and the number of white blood cells in herpetic stomatitis is normal.

4. Histopathological examination: The tissue at the bottom of the vesicle was stained, and multinucleated giant cells were observed. Eosinophil particles were found in the nucleus. Under the electron microscope, the herpes simplex virus was found to be second only to the center of the nucleus.

Differential diagnosis

The disease should be differentiated from herpes angina caused by Coxsackie A virus.

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