Thread by @guerreroespejo

An 81-YO👵, type 2 DM: malaise, fever & anorexia, with oral pain & odynophagia, yellowish-white, pseudomembranous lesions on the tongue (A)

#endoscopy showed multiple shallow ulcers with a white coating (B)
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doi.org/10.1503/cmaj.2…
#emergency #gastroenterology #MedEd

Glossal & esophageal🔬: multinucleated cells with moulded, ground-glass nuclei

PCR & immunohistochemical staining of the specimens: ➕ for herpes simplex virus type 1 (HSV-1)

HERPETIC GLOSSITIS AND ESOPHAGITIS
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#GIPath #IDtwitter #microbiology

Her hemoglobin A1c was 7.2%.

Doctors treated her with a 7-day course of acyclovir, intravenously because of her odynophagia, and the oral and esophageal lesions completely resolved.
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#MedStudentTwitter #MedicalStudents

Herpes labialis is the most common manifestation of HSV-1 infection, accounting for about 90% of reactivated infections.

In contrast, herpetic glossitis and esophagitis are uncommon manifestations of HSV-1 infection.
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#resident #medicine #MedTwitter

Findings of herpetic glossitis including:
✔️single or multiple vesicles
✔️ulcers
✔️linear or crosshatched fissures &
✔️pseudotumoral plaques

Differential diagnosis:
✔️oral candidiasis
✔️syphilis
✔️tuberculosis
✔️pemphigus
✔️lichen planus &
✔️hairy leukoplakia
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#virology

Herpetic glossitis can coexist with herpetic esophagitis,

Herpetic esophagitis characteristically manifests as well-circumscribed ulcers that are sometimes described as having a volcano-like appearance.
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#GITwitter #resident #medicine #Doctor