Jasmina Dovnik
Zdravstveni dom Ormož, Ormož, Slovenija

Liza Lea Lah
Otroški oddelek, Splošna bolnišnica Celje, Celje, Slovenija

Abstract

We present the case of a previously healthy 17-year-old who presented to the Emergency Department because of fever and significant ulcerations of the oral mucosa. Stevens- Johnson’s syndrome and MIS-C were ruled out. He had recent contact with his girlfriend who occasionally has her-pes labialis. HSV-1 was detected from the ulceration on the lower lip. He had no previous history of herpetic ulcers and was found to be seronegative for HSV-1 and HSV-2. Further ulcers appeared all over the oral mucosa, and he had severe gingivitis of the upper and lower jaw, which made it very difficult to eat or drink. He was treated with intravenous flu-ids, local anaesthetic and valacyclovir for 10 days. His fever subsided on the second day of treatment. After treatment, changes to the oral mucosa and gums regressed and completely resolved within two weeks. A significant specific antibody response to HSV-1 was found six weeks after the primary infection. This case is interesting because late clinically significant infection with HSV-1 in healthy immunocompetent individuals in this age group is very rare.

Key words: gingivostomatitis, COVID-19, HSV-1