Abstract
A 29-year-old female patient, 90 days after hematopoietic stem cell transplantation (HSCT) due to severe aplastic anemia, presented with small ulcers spread over the hard palate and a painful ulcer of 1 cm in diameter in the region of the left lingual alveolar mucosa. The patient had cytomegalovirus viremia and had red blood cells and platelets transfused weekly. Cytology confirmed the diagnosis of herpes simplex virus (HSV) in the ulcer of alveolar mucosa and nonspecific inflammatory process in the palate, compatible with graft-versus-host disease (GVHD). Treatment with systemic acyclovir was initiated, with HSV ulcer remission in 7 days. After 3 days, new lesions appeared, and the treatment was extended. The treatment of viral manifestations concomitant with oral manifestation of GVHD is a challenge in patients post-HSCT. The correct diagnosis and the therapeutic choice are extremely important for a better evolution in these highly complex cases.
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