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He gave a history of ulcers in the entire mouth since 2?days. Medical history revealed that he was suffering from fever and generalised weakness. He had not taken any medical or dental treatment for the problem. Family history was unremarkable. On intraoral examination, gingiva appeared fiery red in meprobamate colour and multiple vesicles were present on the attached mucosa (figure 1A). Multiple vesicles and ulcers were seen along the lateral border and anterior surface of the tongue (figure 1B). Both sided buccal mucosa revealed multiple vesicles and papules. These ulcers coalesced together, thereby giving a geographic map like configuration (figure1C,D). On the basis of clinical features, diagnosis of acute primary herpetic gingivostomatitis was made. Treatment started immediately and the patient responded well showing healing of lesions after 2?weeks (figure 2). Figure?1 A 32-year-old male patient presenting with acute primary herpetic gingivostomatitis:(A) Multiple vesicles on both keratinised and non-keratinised mucosa. The gingiva is fiery red in colour. (B) Multiple ulcers present along the lateral border and anterior ... Figure?2 Photographs of the same patient, 2?weeks after treatment showing complete healing of the lesions as seen on gingival (A), tongue (B), both-sided buccal mucosa (C and D). Investigations The diagnosis of primary herpetic gingivostomatitis is generally defined by the clinical data, and no confirmative tests are necessary.1 The available investigations are: Viral culture is considered the gold standard and the most sensitive of the diagnostic techniques, but is generally limited to the hospital setting. Direct immuno?uorescence technique also not readily available and is restricted to hospital setting. Tzanck test demonstrates multinucleated epithelial giant cells which are consistent with a herpes virus infection. It generally detects only about 60% of herpes simplex virus (HSV) infections. Smears also yield no information as to whether the viral agent is HSV-1, HSV-2 or Varicella zoster virus. Differential diagnosis Recurrent herpes simplex infection Major apthous stomatitis Erythema multiformae Treatment The patient was instructed to eat nutritious, soft, blend diet and the following medications were prescribed: acyclovir 200?mg five times a day, to be rinsed and swallowed. benzydamine hydrochloride mouthwash (0.15?g/100?mL)was prescribed for symptomatic relief from burning sensation. Analgesics and antipyretics (Aceclofenac 100?mg and Paracetamol 500?mg) were given to address fever and malaise. Outcome and follow-up The patient responded well to the medication and complete healing was seen after 2?weeks (figure 2). Discussion Two of the known Herpesviridae, herpes simplex viruses type 1 (HSV-1) and HSV-2, are responsible for primary and recurrent mucocutaneous herpetic infections.