Recurrent Intraoral Herpes (RIH) Infection

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Recurrent Intraoral Herpes (RIH) Infection – A Case Report

Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3

Abstract

Recurrent intraoral herpes (RIH) appears to be an infrequent problem. The lesions of RIH are characteristic and can usually be distinguished from others. The lesions of intra oral herpes may persist and be very serious in patients with a compromised immune system. Here we present a case of recurrent intraoral herpes infection in a young female which is uncommon. Introduction The herpes comes from greek word meaning to creep or crawl [1]. The human herpes virus family is officially known as Herpetoviridiae. Humans are only natural reservoir for these viruses, which are endemic worldwide & share many features. Best known member is Herpes Simplex Virus which exists in two types i.e. HSV -1 & HSV-2 [2]. Oral infection with herpes virus occurs in three clinical forms. The most common type consists of recurrent small blisters on the lips commonly referred to as fever blisters or secondary herpes labialis. The second type is a generalized oral infection called primary herpetic stomatitis. The third and least common form of recurrent oral herpes infection consists of small ulcers usually localized on palatal mucosa [2]. Recurrent intraoral herpes appears to be an infrequent problem. The lesions of RIH are characteristic and can usually be distinguished from others. The lesions of intra oral herpes may persist and be very serious in patients with a compromised immune system. While the virus may regress, it does not disappear [3]. Case Report A 26 year old female patient reported to the Department of Oral Medicine & Radiology with a chief complaint of soreness in the roof of mouth since 1 day (Figure 1). There is history of difficulty in swallowing food & patient finds it difficult to chew solid foods because of the burning sensation that is constantly present since 2 days. Patient also gave history of mild fever, nausea, malaise & loss of appetite since 1-2 days. Patient gave history of emotional stress due to family feuds since 3-4 months. Patient also reported a history of recurrent ulcers in mouth with fever & chills about 1-1.5 years back for which patient took medications from a local practitioner & practitioner informed patient it to be a viral infection. Anamnesis was non contributory. On intra oral examination multiple crops of thin walled vesicles surrounded by an inflammatory base each measuring to about 1-5 mm in size having round shape present all over left half of hard palate extending beyond midline of palate. On palpation vesicles were tender & firm in consistency & rupture on digital pressure discharging fluid from within (Figure 2).Investigations carried out were routine hematological tests (within normal range except Hb% which was low), HIV 1&2(nonreactive) & exfoliative cytology. Then smear was sent for histopathologic examination which revealed clusters of altered epithelial cells that show balloning degeneration with enlarged nuclei, condensed chromatin & multinucleation, features suggestive of Herpes Simplex Virus infection (Figure 3). Based on history, clinical & histopathological examination a final diagnosis of Recurrent Intraoral Herpes Simplex Virus infection was put forth. Treatment plan for the patient included, oral hygiene instructions, soft bland diet advised & Paracetamol 500mg tablet on SOS basis. Followup was done after 1 week (Figure 4).

Authors and Affiliations

Sumit Bhateja, Geetika Arora, Santosh Kumar Mastud

Keywords

RIH; HSV; Infection

EP ID EP569494
DOI 10.26717/BJSTR.2017.01.000241
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