Ddx

HSV gingivostomatitis is differentiated from herpangina,

a manifestation of enteroviral infection, by the location
of ulcers in the anterior portion of the oropharynx.
Herpangina generally causes posterior pharyngeal ulcers.
In addition, unlike HSV infection, herpangina often has a
more acute onset, a shorter duration, and seasonal
occurrence.
286  Whereas enterovirus-associated hand, foot, and
mouth disease can manifest as oral ulcers and a vesicular
eruption on the distal portions of extremities, its bilateral
distribution should differentiate it from HSV gingivostomatitis
and concurrent HSV autoinoculation of a digit.
Severe Stevens-Johnson syndrome (erythema multiforme)
may mimic HSV infection, but the generalized macular

ash accompanied by “bull’s-eye” lesions is characteristic

of erythema multiforme. Rarely, recurrent HSV infection
can be associated with erythema multiforme (see later
discussion).
Impetigo may be confused with the lesions of
HSV infection, and misdiagnosis is reinforced because
colonization of skin by Staphylococcus aureus  may be
identified
in bacterial cultures and be considered causative.
Parents and caregivers are familiar with “cold sores”
or “fever blisters” but may not know that these lesions
are caused by HSV.
Diagnosis Banding Herpes
Herpes Simpleks 1 dan Herpes
Simpleks 2
Gingivostomatitis
Vulvovaginitis
Herpes Whitlow
Herpes Ocular
Infeksi Saraf Pusat
Penyakit
Syphillis, Lymphogranuloma
venereum, Behcet disease, Scabies,
Varicella zoster, Hand foot and mouth
disease, Steven Johnson Syndrome,
Chicken pox,
Apthous Stomatitis, Steven Johnson
Syndrome, Erythema Multiforme,
Herpangina, Chron disease, Infectious
mononucleosis, Lip cancer,
Herpes zoster, Vulvovaginal
candidiasis, syphilis, syphilis,
chancroid, lymphogranuloma venerum,
donovanosis, and hand foot and
mouth-disease.
Blistering Dactylitis, acute or chronic
Paronychia.
Herpes zoster ophtalmicus,
acanthamoeba, microbial keratitis,
blepharitis, allergic conjungtivitis,
bacterial and viral (other than HSV)
conjungtivitis.
Meningitis
 Bacterial meningitis (e.g.,
Neisseria meningitidis,
Haemophilus influenzae,
Streptococcus pneumoniae),
Kawasaki disease.
Ensefalitis
 Mycoplasma pneumoniae
encephalitis, Subacute
sclerosing encephalitis
(measles virus)
Meningoenchepalitis
 Viral meningoenchepalitis
cause by other than HSV
( enterovirus, parechovirus),
Amebic meningoencephalitis,
Tick-borne encephalitis virus
Milaria, congenital sucking blister,
 Herpes Neonatus cytomegalovirus, toxoplasmosis,
Syphilis, Rubella.

Infections
Fungal
Cryptococcus spp.
Coccidioides immitis
Histoplasma spp.
Bacterial
Abscess, cerebritis
Listeria monocytogenes meningitis
Borrelia burgdorferi meningitis
Subdural, epidural empyema
Mycobacterium tuberculosis meningitis
Bacterial endocarditis
Bacterial meningitis (e.g., Neisseria meningitidis,
Haemophilus influenzae, Streptococcus pneumoniae)
Mycoplasma pneumoniae encephalitis
Protozoal
Toxoplasmosis
Amebic meningoencephalitis
Rickettsial
Viral
Mumps virus
Coxsackievirus, echovirus
Arbovirus (St. Louis, California, eastern and western
equine encephalitis, West Nile virus)
Influenza
Reye syndrome
Lymphocytic choriomeningitis virus
Rabies virus
Epstein-Barr virus
Human herpesvirus–6
Rubella virus
Cytomegalovirus
Adenovirus
Tick-borne encephalitis virus
Powassan virus
Subacute sclerosing encephalitis (measles virus)
Progressive multifocal leukoencephalopathy
Acute disseminated encephalomyelitis (ADEM)
Noninfectious Disorders
Tumor
Vascular disease
Arteriovenous malformations
Toxins
Alcoholic encephalopathy
Leukemia
Cerebral infarction
Subdural or epidural hematoma
Adrenal leukodystrophy