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.