Primary herpes simplex virus infection
treated with acyclovir

A 21 year old woman presented with severe dysphagia, fever of up to 38o C and submandibular lymphadenopathy of one week's duration. Clinical examination revealed mildly swollen, erythematous and painful gingivae, and extensive ulceration of the tongue which was covered by pseudomembranes [figure]. One week after initiation of treatment, the oral lesions were healed but multiple vesicles, some of them ruptured, had appeared on her finger [figure]. Two months later the patient developed multiple confluent vesicles on the tongue [figure] and a week later, her boy friend presented with erythematous, swollen, painful gingivae [figure] and multiple vesicles on the tongue and the lower lip [figure], and low grade fever.

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