text: The herpes infection has a history dating back to ancient Greece.  The word 'herpes' was used by Hippocrates to describe lesions that 'creep' or 'crawl.'  Although previously well characterized, it was not until 1893 that the transmissibility was recognized.6\n\nThe herpes family of viruses currently is thought to consist of herpes simplex 1 (HSV-1), herpes simplex 2 (HSV-2), varicella-zoster, Epstein-Barr, cytomegalovirus, and human herpes virus VI, VII, and VIII.5  All are capable of entering and replicating in epithelial cells, while some of the herpes family is neurotropic and others are lymphotropic.  HSV-1 and HSV-2 are neurotropic, infecting sensory nerve fibers and have been demonstrated to reproduce in epithelial cells.  HSV-1 and HSV-2 are lytic to human epithelial cells and latent in neural tissue at the site of regional ganglions.  Usually the virus initially enters the body through a break in the mucous membrane integrity, although there is evidence that it may penetrate intact skin.  In either case, transmission results from mucocutaneous contact with infected secretions and aerosols.  When reactivated, the virus travels along the nerve axon to the surface epithelial cells and can cause a recurrent epithelial outbreak.\n\nOften the initial herpes infection goes undetected.  However, in a small percentage of cases, the initial oral infection with HSV-1 or HSV-2 is acutely symptomatic causing many signs and symptoms detected by the patient.  When the patient demonstrates systemic signs, symptoms, and has perioral and intraoral vesicular lesions, it is referred to as primary herpetic gingivostomatitis.  Although the condition most often occurs in children, it can also affect adolescents and adults.  Fever and lymphadenopathy may occur, lasting from 2-10 days.  Pharyngitis, malaise, myalgia, fiery red gingival, and mucosal tissues associated with painful swallowing are hallmarks of the primary infection.  Intraorally, many small punctate ulcers may form on keratinized and nonkeratinized mucosa as well as at the nasopharynx.  Perioral tissues can also be affected.\nhttp://www.thejcdp.com/issue009/tilliss/10tillis.htm