Painful ulcers on gingiva, tongue, and buccal mucosa
The Journal of Family Practice. 2019 October;68(8):465-467
October 7, 2019|Family Medicine
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We had one clue that helped explain the ulcers in the patient’s mouth: He had an accompanying low-grade fever.
Prompt use of antivirals is key
Treatment of acute HSV gingivostomatitis involves symptomatic management with topical anesthetics, oral analgesics, and normal saline rinses.1 Acyclovir is an established therapy; however, it has poor bioavailability and gastrointestinal absorption.1 Valacyclovir has improved bioavailability and is well tolerated.1 For primary herpes gingivostomatitis, we favor 1 g twice daily for 7 days.1 Our patient responded well to this valacyclovir regimen and healed completely in 1 week.
CORRESPONDENCE
Robert T. Brodell, MD, 2500 N State St, Jackson, MS 39216; rbrodell@umc.edu
