Pathology · patient case question
A child with primary herpetic gingivostomatitis and fever should NOT be given which analgesic?
Patient case: Vesiculobullous Disease
demo: 55-year-old female
chief: “Spicy food burns terribly and my gums peel.”
history: Six-month history of oral ulceration preceding any skin involvement. No fever.
meds: None
findings: Diffuse buccal mucosal erythema with ragged erosions, desquamative gingivitis, and flaccid bullae that rupture readily. Gentle lateral pressure on adjacent normal-appearing mucosa produces a new blister.
Show answer and explanation
Correct answer: A. Aspirin, because of the risk of Reye syndrome
- A. Correct. Aspirin given to a child with a viral illness carries a risk of Reye syndrome — acute encephalopathy with hepatic steatosis.
- B. Ibuprofen is acceptable in a well-hydrated child and carries no Reye risk.
- C. Topical anesthetic is used cautiously and sparingly, with attention to total dose, but it is not contraindicated.
- D. Acetaminophen is the standard antipyretic and analgesic for these children.