Case presentation
A49 years old female was referred to the Oral medicine and
periodontology clinic, Faculty of Dentistry, Mansoura University for
further evaluation of a painful lesion on the hard palate that appeared
10 days after the clinical signs and symptoms of COVID-19 infection as
sore throat, fever, fatigue, bone pain, headache, and dry cough.
Intraoral examination revealed unilateral vesicles filled with clear
fluid as well as painful erythematous areas involving one side of the
hard palate which was preceded by initial stabbing pain. The pain was
continuous, severe, and stabbing. The vesicles were small and few in
numbers. Later, they increased in number with watery discharge. The
palatal mucosa surrounding the vesicles was tender to touch. Fig1
Extraoral examination showed unilateral palpable submandibular and
cervical lymph nodes. No swelling of the neck, no TMJ clicking, or
tenderness of muscles of mastication. The medical history showed
hypertension, osteoarthritis, and maxillary sinusitis.
Laboratory investigations revealed lymphopenia, neutrophilia, elevated
levels of serum alanine aminotransferase and aspartate aminotransferase,
elevated lactate dehydrogenase, and High C-reactive protein. Chest x-ray
and CT were consistent with COVID-19 Infection. Fig2&3
The patient has been prescribed acyclovir 800mg tablets five times per
day for 10 days as well as topical antiseptics with chlorhexidine. In
addition, paracetamol was prescribed for pain and fever. After 10 days,
the patient showed full recovery of the oral lesions.