Atypical Clinical Manifestations of Herpes Simplex Virus-1 Infection.

Introduction: The Herpes Simplex Virus-1 (HSV-1) infection of the oral cavity is a disease that initiates with prodromal symptoms such as fever and malaise, followed by the emergence of oral and perioral lesions. The common clinical manifestations of HSV-1 infection involve the development of vesicles on the face, oral mucosa and lips, which eventually progress to ulceration. This case report aims to present an atypical clinical manifestation of HSV-1 infection.

History and clinical findings: A 62-year-old woman presented with complaints of a lump at the corner of her left lip, which had disappeared but reappeared. Six weeks ago, the lump started as a white spot, then gradually enlarging, becoming painful, and ruptured. The patient went to the clinic for treatment and was given gentamicin ointment, but there was no improvement. Extraoral examination showed a nodule in the corner of the left lip measuring 1 × 2 cm, filled with purulent exudate. Serological examination revealed reactive anti-HSV-1 IgG results, leading to a diagnosis of Herpes Labialis.

Case management: Pharmacological therapy comprised antivirals and multivitamins. The lesion resolved after 10 days of treatment with no reported recurrence during the three-month evaluation.

Conclusions and recommendations: HSV-1 infection presents with a variety of clinical features, including typical signs of vesicles, ulceration, and also other atypical forms of lesions. A comprehensive history accompanied with supporting examinations is crucial to identifying the diverse clinical manifestations of herpes simplex virus-1 infection.