Oral Allergy Syndrome Caused By Japanese Radish: A Case Report

Background: Oral allergy syndrome (OAS) is a type of food allergy that manifests as hypersensitivity symptoms of the oropharyngeal mucosa on ingestion of specific foods with oral findings resembling herpetic gingivostomatitis. Symptoms can also appear in parts other than the oral cavity. There are a few reports of OAS caused by consuming radishes in the literature.Case presentation: A 31-year-old male presented to our department with stomatitis and pharyngeal pain. The patient did not have a history of allergy, and herpetic gingivostomatitis was suspected. He was admitted to the emergency room of our hospital after complaining of oral and epigastric pain a few days later. On admission, symptoms noted were similar to those when he first visited our department. After detailed history taking, he reported consuming raw Japanese radish frequently, which gave rise to his symptoms. Radish was strongly suspected as the causative allergen. The skin prick test result was positive, confirming the diagnosis of OAS.Conclusions: OAS can be diagnosed easily once the food causing symptoms is identified. However, guiding the diagnosis can be challenging if the patient is unaware of food allergies. Upon encountering widespread erosion in the oral cavity, it is essential to consider OAS as the possible cause.

Oral Allergy Syndrome Caused by Japanese Radish: A Case Report

Background:Oral allergy syndrome (OAS) is a type of food allergy that manifests as hypersensitivity symptoms of the oropharyngeal mucosa on ingestion of specific foods with oral findings resembling herpetic gingivostomatitis. Symptoms can also appear in parts other than the oral cavity. There are a few reports of OAS caused by consuming radishes in the literature.Case presentation:A 31-year-old male presented to our department with stomatitis and pharyngeal pain. The patient did not have a history of allergy, and herpetic gingivostomatitis was suspected. He was admitted to the emergency room of our hospital after complaining of oral and epigastric pain a few days later. On admission, symptoms noted were similar to those when he first visited our department. After detailed history taking, he reported consuming raw Japanese radish frequently, which gave rise to his symptoms. Radish was strongly suspected as the causative allergen. The skin prick test result was positive, confirming the diagnosis of OAS.Conclusions:OAS can be diagnosed easily once the food causing symptoms is identified. However, guiding the diagnosis can be challenging if the patient is unaware of food allergies. Upon encountering widespread erosion in the oral cavity, it is essential to consider OAS as the possible cause.

Adolescents and primary herpetic gingivostomatitis: an Italian overview

Aim The aim of this study was to investigate the therapies administered to Italian adolescents with primary herpetic gingivostomatitis (PHGS) Methods The medical records of 74 adolescents with PHSG were reviewed. The following data were recorded: age, gender, day of onset, type of treatment, lesions’ severity, pain scoring, eating, and drinking ability. The oral examination was performed at the first evaluation (T0) and after one week (T1). Results All patients showed up at the first visit at least 48 h after the onset of symptoms. No patient was prescribed an antiviral therapy. An antibiotic therapy was prescribed in order to prevent secondary bacterial infections. Fifteen patients had been treated with non alcoholic chlorhexidine rinses (group A), 29 patients with non alcoholic chlorhexidine rinses plus hyaluronic acid gel (group B); 30 patients with non alcoholic chlorhexidine rinses plus Mucosyte® (group C). A significant improvement of the pain scoring and lesions’ severity was noted in group C. Conclusion In Italian adolescents, PHGS is diagnosed at least 48 h after onset and the antibiotic therapy is widely prescribed in order to prevent overinfections. Among topical therapies, an association of verbascoside and sodium hyaluronhate seems to favour a faster healing.

PERAWATAN GINGIVOSTOMATITIS HERPETIKA PRIMER PADA PASIEN REMAJA

Primary Herpetic Gingivostomatitis (PHGS) is a primary infection to Herpes Simplex Virus type 1 (HSV-1). PHGS often occurs in pre-school-aged children, but also occur in school-age children and teenager. This case report purpose to discuss management of PHGS in teenager. Patient a 12-year-old with chief complaints are many ulcers in mouth. Ulcer appears after the patient has a fever for 2 days. The patient has never experienced like this before. On Intra Oral examination found multiple ulcers, varying in size, pain in the upper labial, lower labial, lower gingival and lower mucobucalfold. Patient was given a complete blood count and IgG antigen HSV-1, with reactive results. Patients received treatment in the form of aloe vera extract gel, Immunomodulator syrup. ulcers healed after 12 days of treatment. Primary Herpetic Gingivostomatitis caused by HSV infection. This case often occurs in children but does not rule out the possibility that it can occur in teenager, adults and the elderly. Management in this case is aimed at pain control by topical analgesics and supportive therapy with immunomodulatory. In this case, a proper history and examination, accompanied by laboratory examinations, is needed to establish a diagnosis and cooperation between dentists and patients to accelerate recovery.

ORAL MANIFESTATIONS OF VIRAL INFECTIONS IN CHILDREN

Viral diseases with oral manifestations are common in the practice of pedodontist, however, sometimes their diagnosis is complicated due to the similar clinical manifestations. A huge number of viruses are present in oral cavity, especially from Herpesviridae family, however, the most of them are asymptomatic. Cold, systemic diseases and stress provoke the activation of viruses with different clinical manifestations. Therefore, a dentist can be the first who diagnoses not only herpetic gingivostomatitis, but also other viral diseases. The aim of the article was to analyse the oral manifestations of viral diseases in children in order to optimize their diagnostics. This article analyses clinical cases and reviews of diseases in English in Google database from 2011 to May 2020 (and earlier publications) by Keywords: «herpetic gingivostomatitis», «recurrent aphthous stomatitis», «oral manifestations of infectious mononucleosis», «herpetic angina», «oral manifestations of cytomegalovirus infection», «recurrent herpetic gingivostomatitis», «oral manifestations of varicella virus», «oral manifestations of herpes zoster», «roseola infantum», «herpangina», «hand, foot and mouth disease», «oral manifestations of measles», «rubella», «oral manifestations of papillomavirus», and «oral manifestations of human immunodeficiency virus». Viruses which have oral manifestations were characterized by transmission. Mostly airborne viruses are represented by Herpesviridae family. The differential diagnosis of primary herpetic gingivostomatitis includes recurrent aphthous stomatitis which forms ulcers on non-keratinised oral mucosa without a vesicle phase. Recurrent herpetic infection doesn’t have difficulties in diagnostics, but could be complicated by erythema multiform with clear target lesions. Vesicles, erosions in oral cavity associated with vesicles on hear part of head help to distinguish chickenpox from herpetic infection. Compared to Herpes simplex virus infection, Herpes zoster has a longer duration, a more severe prodromal phase, unilateral vesicles and ulceration, with abrupt ending at the midline and postherpetic neuralgia. Roseola is characterized by small papules on skin and palate which appears when severe fever in prodromal period subsides and disappears after 1-2 days. Oral vesicles associated with foot and hand rush differentiate enterovirus stomatitis from chickenpox and roseola. The distribution of the lesions of herpangina (palate, tonsils) differentiates it from primary herpetic gingivostomatitis, which affects the gingivae. Comparing with roseola and rubella, measles has a bigger size of rush and specific oral localization on buccal mucosa. Mild fever and skin rush which appears on face and extensor surfaces of body and extremities help to distinguish rubella from measles and roseola. Viruses transmitted through biological liquids are represented in oral cavity by infectious mononucleosis and cytomegalovirus. The vesicles and ulcers on the tonsils and posterior pharynx in case of these infections can resemble herpetic stomatitis, but liver and spleen enlargement allows to exclude this diagnose; also cytomegalovirus erosions heal for long time. Cervical lymphoadenopathy differentiates them from herpetic angina. Laboratory diagnostics is based on detection of antibodies to virus or virus DNA in blood helps to make diagnosis of infectious mononucleosis and cytomegalovirus infections. Viruses transmitted through direct contact with mucosa and biological liquids represented by human papillomavirus (HPV) and human immunodeficiency virus (HIV). HPV in oral cavity represent by benign epithelial hyperplasia which might persist and transform to malignant. Therefore, histological examination plays important role in diagnostics of HPV. Oral manifestations such as candidiasis, herpes labialis, and aphthous stomatitis represent some of the first signs of HIV immunodeficiency. Oral lesions also associated with HIV in children are oral hairy leukoplakia, linear gingival erythema, necrotizing ulcerative gingivitis, and Kaposi’s sarcoma. Rapid necrotization and long-term healing of oral lesions help to suspect HIV and prescribe the blood test for the detection of antibodies to the virus. Oral mucosa is often the first to be affected by viral infections. A thorough anamnesis and examination is the key to accurate diagnostics of the most oral viral lesions and their adequate treatment. Biopsy, examination of antibodies to the virus in the blood or polymeraze-chain reaction to the virus in the bioptate or blood are performed in case of diagnostic difficulties. Laboratory methods had to use more widely for the diagnostics of recurrent or unclear lesions of the oral mucosa in children.