Evaluates the efficacy of Acyclovir and its analogues in the treatment of recurrent herpes simplex disease. However, some children get numerous small, shallow ulcers on the tongue, gums and mucosa inside the cheeks. Vujevich reports no conflict of interest. These cells also metabolize nearly all absorbed dietary glutamine in addition to extracting circulating glutamine derived from other tissues.2 Oral glutamine, but not parenteral glutamine, has been shown to be effective in reducing the bacteremia and mucosal injury associated with methotrexate-induced enterocolitis.3 The severity of radiation-induced mucosal injury to the intestine also was reduced when oral glutamine supplementation was provided to rats.4-6 Animals given parenteral glutaminase to deplete circulating glutamine develop emesis, diarrhea, mild villous atrophy, mucosal ulceration, and intestinal necrosis.7 Thus, glutamine is important in the preservation of gut integrity and mucosal structure after chemotherapy and radiation. Diabetic ketoacidosis could therefore be eliminated. Furthermore, guinea pigs and mice were prophylactically protected from genital challenge with high doses of wild-type HSV-2. The evaluation of RAU includes a complete history and physical examination to ascertain underlying disease that may be contributing to ulcer formation.
Appropriate testing for allergies and nutritional deficiencies is performed and trauma and stress histories are reviewed. Pharmacologic Considerations: Topical. Amlexanox (Aphthasol) is an anti-inflammatory and anti-allergic agent widely used in Japan for many years. It has been developed as a 5% topical oral paste and is the only US Food and Drug Administration-approved agent for the treatment of RAU. Treatment must be started as soon as symptoms occur. A history of recurrent oral mucosal ulcers, generally starting in childhood, and the typical small round or oval ulcers on exam are key. Brush your gums well to reduce the risk of getting another infection. Pharmacologic Considerations: Systemic.
Oral corticosteroids may be used for relief in severe cases. Presents a study which aims to determine the sensitivity of herpes simplex virus isolates to acyclovir and the importance of resistant isolates in hospitalized patients. This must be followed by a 2-week taper. RAS is typically an isolated finding but may occur as one manifestation of a systemic disease. Figure 1. This medication is contraindicated in both pregnancy and lactation, has an elevated neurotoxicity in the geriatric population, and has some serious side effects (possible bone marrow depression, agranulocytosis, taste disturbances). Vesicular stomatitis virus (VSV) is an enveloped, negative-strand RNA virus of the Rhabdoviridae family.
The effects are only temporary with recurrence after approximately 20 days of therapy. This drug has only limited use in the general population due to well-known risks to childbearing women and must be reserved for only the most severe cases. It has been successfully used in HIV-positive patients who are particularly sensitive to RAU. Given the paucity of data about the patient presented in the original case, no specific instructions can be given. Rather, the patient should be systemically evaluated and treated according to the underlying etiology, classification of lesions, and severity of presentation. Antimicrobial rinses may reduce the number of outbreaks and increase disease-free periods between ulcerations. Coxsackieviruses, echoviruses, newer enteroviruses, and parechoviruses.
Effective preventive measures remain elusive.