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.
Highlights
Orofacial diseases in human are mainly caused by the herpes simplex virus (HSV)
There are two immunologically different types of herpes simplex virus, namely HSV type 1 (HSV-1) which usually occurs in the lips, face, oral cavity and upper body area; and the second one, HSV type 2 (HSV-2) which usually occurs in the genital and lower body areas (Shah et al, 2014)
A general oral infection known as primary herpetic stomatitis, and the third is recurrent intra oral herpes consisting of small vesicles and/or ulcer that usually occurs in the nonkeratinised area (Bhateja et al, 2017)
Summary
Orofacial diseases in human are mainly caused by the herpes simplex virus (HSV). There are two immunologically different types of herpes simplex virus, namely HSV type 1 (HSV-1) which usually occurs in the lips, face, oral cavity and upper body area; and the second one, HSV type 2 (HSV-2) which usually occurs in the genital and lower body areas (Shah et al, 2014). A 41-year-old female patient came to the Integration Clinic, Universitas Indonesia (UI) Dental Hospital She was hit by her child’s head, which had caused several painful canker sores on her lower gingiva (VAS 7/10) for six days. We found canker sores that was reducing in number and pain compared to the initial visit (VAS 4/10) She stated that the outer part of her vagina had vesicles and often feels itchy, red, especially in her periods. A 70-year-old male patient came to UI Dental Hospital with complaints of canker sores for five days He felt pain in the entire mouth (VAS 7/10) and even felt severe headache. The patient was hospitalised for three days and received analgesic-antipyretic therapy, amlodipine, clindamycin, bisoprolol, injection of omeprazole, ranitidine and ceftriaxone He was instructed to apply gel containing triamcinolone acetonide on the canker sores area. Because of the recovery experienced by the patient, we stopped the doxycycline mouthwash and was replaced by gargle with warm salt water (1/4 tablespoon of salt dissolved in 250 ml of boiled water) twice a day
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