1.Challenges in Diagnosis and Therapy of Recurrent Oral Herpes Infection: Study of Two Cases
Dwi Kartika Sari ; Febrina Rahmayanti ; Harum Sasanti ; Ambar Kusuma Astuti
Archives of Orofacial Sciences 2021;16(SUPP 1):73-81
ABSTRACT
The symptoms of recurrent oral herpes infection may vary, from mild discomfort to life threatening.
Dentists are more likely to be consulted in this oral infection, hence the ability to diagnose and treat
this disease is mandatory. This article described manifestation and therapy of recurrent oral herpes
infection. In the first case, a 41-year-old woman came with a complaint of painful sore mouth in her
lower gingiva. She experienced canker sores for two to three times a year on the tongue, lips and palate.
Laboratory results showed positive IgM anti HSV-2, which matched with the primary herpes infection.
However, based on the history and clinical manifestations, she was diagnosed with recurrent intra oral
herpes infection. In the second case, a 70-year-old man came with a very painful canker sores in his
entire mouth. The patient had to be hospitalised for three days and received analgesic, antibiotic and gel
containing triamcinolone. After hospitalisation, canker sores did not heal. Extraorally, we found a crust
in the vermillion border of the upper lip and intraorally, we found multiple ulceration of keratinised and
non-keratinised mucosa. The use of topical steroid in this patient may aggravated ulceration due to its
ability to cause rapid spreading of the virus. The first patient was given chlorhexidine gluconate 0.2% and
the second patient was prescribed with doxycycline rinse. Both patients received multivitamin containing
zinc. Complete history taking, objective and adjunctive examination played a role in establishing the
diagnosis and treatment of recurrent oral herpes infections.
Stomatitis, Herpetic