COLD SORES(Fever Blisters; Herpes Simplex) |
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COLD SORES (Fever Blisters; Herpes Simplex)
DESCRIPTIONCold sores are a common, contagious viral infection. The lips, gums, and mouth area, the cornea (rarely), and the genitals (occasionally) are involved.
Appropriate health care includes:
Self-care after diagnosis.
Doctor's treatment, especially if the eye is affected, in which case it requires continuing physician's monitoring of general condition and medications.
SIGNS & SYMPTOMS
Eruptions of very small, painful blisters--usually around the mouth, but sometimes on the genitals. The blisters are grouped together and are surrounded by a red ring. They fill with fluid, then dry up and disappear.
If the child's eye is infected: eye pain and redness, feeling that something is in the eye, sensitivity to light, and tearing.
CAUSES
Infection with a herpes virus that invades the skin, often remaining for months or years before causing active inflammation. Most persons develop antibodies that control the virus unless risk factors (below) develop.
The virus is transmitted by person-to-person contact or by contact with saliva, stools, urine, or discharge from an infected eye. The blisters and ulcers of herpes simplex are contagious until they heal, both in the first and in succeeding flare-ups.
RISK FACTORS
Eczema in children; physical or emotional stress; illness that has lowered resistance, including a cold, minor gastrointestinal upset, or fever from any cause; excess sun exposure; menstrual periods; dental treatment that stretches the child's mouth; use of immunosuppressive drugs.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should avoid physical contact with others who have active lesions.
Your child should wash hands often during a flare-up to avoid spreading the virus.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory virus cultures (rare).
POSSIBLE COMPLICATIONS
Permanent vision impairment, if herpes eye infections are untreated.
Severe, widespread infection in patients with eczema.
Meningitis or encephalitis (rare).
PROBABLE OUTCOME
Spontaneous recovery in a few days to a week, occasionally longer. Recurrence is common. The virus remains in the body for life, but it is usually dormant. Research continues in developing a vaccine.
TREATMENT
HOME CAREInstructions for your child:
Drink cool liquids or suck frozen juice bars to reduce discomfort.
Apply an ice cube for 1 hour during the first 24 hours after a lesion appears. This may make it heal more quickly.
Don't rub or scratch an infected eye.
To prevent flare-ups, use zinc oxide or sun-screen preparations on your lips when you spend much time outdoors.
MEDICATION
Use acetaminophen to relieve minor pain. Don't use aspirin, especially for children and adolescents. The use of aspirin during some viral illnesses may lead to Reye's syndrome, a form of encephalitis.
Don't try to treat an infected eye--especially with cortisone ointments or drops--without consulting your doctor. Cortisone preparations promote growth of the herpes virus in the cornea.
Your doctor may prescribe:
-- Anti-viral topical or oral medication.
-- Antibiotic ointment if lesions become infected with bacteria.
-- Anti-cancer topical medication for eye infections.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions, except to avoid close contact--especially kissing -- until lesions heal.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
The following occurs with a cold sore:
Signs of secondary bacterial infection, such as fever, pus instead of clear fluid in the lesions, headache, and muscle aches.
Eruption of lesions on the genitals similar to those around the mouth.
New, unexplained symptoms. Drugs used in treatment may produce side effects.
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