Diseases of Infants And Children

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A purulent exudate is then formed that goes on to necrosis and the formation of an ulcer. As a rule, the preliminary stages are not observed. An ulceration on the gum margin which spreads even to the buccal por- tion of the gum is the usual picture. In aggravated cases the tooth is exposed and loosened in its socket. The odor is distinctly fetid and quite characteristic of this form of mouth disease. Drooling is pro- nounced. The cheek and lips may also be involved by contact, and even necrosis... of the jaw may follow in the pathological process. The neighboring lymph-glands become hypertrophied.
Course and Prognosis. The prognosis depends greatly upon the vitality of the child. In poorly nourished, anemic children, it may run an obstinate course of several weeks. As a rule, it begins to clear up after the first week.
Differential Diagnosis. The almost typical picture, with the fetid breath, salivation, and localization on the gums, stamps the disease quite clearly. In gangrenous stomatitis we have marked and early constitutional symptoms and prostration, with a limited dark, pur- plish area of tissue involved.


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