Oral lesions of viral, bacterial, and fungal diseases in children: A decision tree

Charlotte Guillouet; Margot C Riou; Lucas T Duong; Muriel de La Dure-Molla; Benjamin P J Fournier

doi:10.3389/fped.2022.937808

Oral lesions of viral, bacterial, and fungal diseases in children: A decision tree

Front Pediatr. 2022 Jul 25:10:937808. doi: 10.3389/fped.2022.937808. eCollection 2022.

Authors

Charlotte Guillouet^{1

2

3}, Margot C Riou^{2

3

4}, Lucas T Duong^{4

5

6}, Muriel de La Dure-Molla^{2

3

7}, Benjamin P J Fournier^{3

4

8}

Affiliations

¹ Laboratory of Embryology and Genetics of Human Malformations, INSERM UMR 1163, Institut Imagine, Université Paris Cité, Paris, France.
² Université Paris Cité, Dental Faculty, Department of Pediatric Dentistry, Paris, France.
³ AP-HP, Rothschild Hospital (ORARES), Dental Department, Reference Center for Oral and Dental Rare Diseases, Paris, France.
⁴ Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, INSERM UMRS 1138, Molecular Oral Pathophysiology, Paris, France.
⁵ AP-HP, Charles Foix Hospital, Oral Surgery Department, Paris, France.
⁶ Gustave Roussy, Paris-Saclay University, Department of Head and Neck Surgical Oncology, Villejuif, France.
⁷ Bases Moléculaires et Physiopathologiques des Ostéochondrodysplasies, INSERM UMR 1163, Institut Imagine, Université Paris Cité, Paris, France.
⁸ Université Paris Cité, Dental Faculty, Department of Oral Biology, Paris, France.

Abstract

Oral mucosal lesions are common in the pediatric population and, apart from traumatic and tumoral etiologies, they can be symptoms of viral, bacterial, fungal or parasitic diseases. Yet, pediatricians and pediatric dentists find it challenging to reach a diagnosis and provide appropriate care when facing lesions of the masticatory or lining mucosa, of the hard or soft palate, of the tongue or salivary glands. Here, we propose a decision tree for the diagnosis of the most frequent viral, bacterial, and fungal diseases starting from their oral lesions in children. By first focusing on describing the elementary lesion itself before its localization and characteristics, it aims to guide the practitioner toward the diagnosis and any necessary complementary exams. To generate this tool, we conducted a literature review of the childhood viral, bacterial, fungal and parasitic diseases with oral mucosal symptoms. For each of the 42 reported diagnoses-20 viral, 9 bacterial, 5 fungal, and 8 parasitic-we collected the infection mechanism and agent(s), the oral lesions and their description, the associated systemic signs and the incidence/prevalence. In fine, our decision tree indexes the 28 diseases for which epidemiological data was available, mainly in Europe and the United States.

Keywords: communicable diseases; decision trees; mouth mucosa; oral manifestations; oral medicine; pediatric dentistry.