April 1987

Picture of the Month

Author Affiliations

(Section Editor)
Contributed from the Department of Pediatrics, Allentown (Pa) Hospital.

Am J Dis Child. 1987;141(4):447-448. doi:10.1001/archpedi.1987.04460040105027

Denouement and Discussion 

  • It is uncertain whether streptococcal pharyngitis (Fig 1) can be transmitted during the incubation period (two to five days). In untreated patients, communicability is maximal during the acute onset of the infection and then steadily decreases, most likely because of a decreasing amount of M protein.

  • Nystatin is most effective in treating candidiasis (Fig 3) when the disease is present only in the oral cavity and there is no systemic involvement. Also recommended is clotrimazole troches, although its safety and effectiveness have not been established in children less than 3 years old.

  • Gingivostomatitis present in primary herpes zoster virus infection (Fig 2) may also be associated with fever, irritability, and enanthem involving the gingiva and mucous membranes of the mouth. After the primary infection, the virus remains latent. When it reactivates, the most common manifestation is a cold sore.

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