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Painful blisters on gums and swollen facial glands. Could this be herpes virus?

Answered by
Dr. Kalpana Pathak


Practicing since :2006

Answered : 2015 Questions

Posted on Wed, 30 Jan 2013 in Dental Health
Question: I started with two blisters on my gums 4 days ago. By the second day there were more and they were painful, turning into sores from blisters. Went to dentist 2nd day, she didn't think it was a dental issue and thought maybe a virus. She gave me antibacterial rinse just to help any bacteria from invading the sores.
Since then those lesions are still sore but not as scary looking but new blisters are forming now in a different location at the back if my mouth. All is on the left side. My left facial glands are swollen- parotid? Has a hard pea size lump. There are also other swollen glands on my left side. But the most alarming to me is the numbness on my left cheek, it also feels swollen and weird on my whole left side but I can't see the swelling, just feel it.
In general I've felt run down. I'm a 33 yr old otherwise healthy female, active, 129lbs. My husband has had cold sore flare ups in the past... Could this be a herpes virus from him?
Answered by Dr. Kalpana Pathak 1 hour later

Welcome to XXXXXXX

From the description of the lesions, I can think of two differentials-
1) herpes zoster( shingles)
2) herpes simplex infection( cold sores) that you might have acquired from your spouse.

Both of these can involve oral cavity. However involvement of single side of oral cavity, swelling of face and numbness of cheek (possibly due to nerve involvement) points probably towards diagnosis of shingles.

The treatment of both of these infections involves use of antivirals( acyclovir or valacyclovir or famciclovir) along with the use of painkillers( ibuprofen, tramadol , gabapentin, pregablin etc) and oral antibiotics as per the requirement. However the dose and duration of treatment depends on the type of infection.

I would also like to emphasize that cold sores have a tendency to recur and shingles might heal with residual neural pain and therefore appropriate treatment in either of these cases is mandatory. Hence a consultation with dermatologist for proper examination and appropriate treatment is necessary.

Use of antibacterial rinse is justified to prevent super-added bacterial infection.
Both of these infections can be treated effectively, so there is nothing to worry.

Hope I have answered your query. Should there be further questions, I would be more than happy to oblige.

Take care.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
Follow up: Dr. Kalpana Pathak 7 hours later
I have an appointment with my gp on Tuesday to follow up with him. Is there any test to confirm which herpes? Also I feel like my symptoms are maybe starting to gradually improve... Is that typical of the viruses you mentioned or would I need the antiviral to clear it? Can shingles occur without a body rash?
Thank you for your informative answer.
Answered by Dr. Kalpana Pathak 3 hours later

A simple test known Tzanck smear test can be done to confirm herpes virus infection.

To differentiate whether it is herpes zoster virus infection, more advanced serological tests are required. However they are not routinely used as diagnosis can be appropriately made by clinical examination alone.

Both of these infections are self limiting and hence the gradual improvement in the symptoms is being noticed by you.

Antivirals are usually effective when started within 3 days of beginning of the symptom. You might not require them if the symptoms are resolving. But if the lesions have not resolved completely or if you are still developing more blisters, antivirals will be required to contain viral activity. Nevertheless continue with your antibacterial mouth wash to prevent any super added bacterial infection.

Shingles can occur without body rash too (known as zoster sine herpeticum); but in your case you are having oral blisters along with other manifestations.

Do visit your GP on Tuesday for sure! I will be available for further assistance if you need any.

Wish you a healthy recovery...

Take care

P.S: Please close this discussion and review your experience about this service, if you have no more queries to me.

Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

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