A 14-year-old female with Down syndrome visited our hospital with a fever. During hospitalization, fever persisted, and pancytopenia was observed, so evaluation was performed, hemophagocytic lymphohistiocytosis (HLH) was diagnosed, and chemotherapy began. Three weeks after chemotherapy, ulcerative lesions with white patches on the oral mucosa, gingiva, and lips were observed (Fig. 1). Polymerase-chain-reaction (PCR) test for herpes simplex virus type 1 (HSV-1) on specimens taken from the patient’s oral mucosa and blood have tested positive. In addition, Candida glabrata was identified in the fungal culture of the oral lesion. The chest radiography, lumbar puncture test, and liver biochemical tests were normal. HSV-1 gingivostomatitis with oral candidiasis was diagnosed. The patient was given intravenous, topical acyclovir and oral fluconazole syrup. Two weeks later, oral and lip lesions improved.
Fig. 1.
a 14-year-old female with lip and tongue ulcers with white patches.
Ethical approval
Written informed consent for publication of clinical case details was obtained from the patient’s guardian.
CRediT authorship contribution statement
Park E.: Conceptualization, Writing - original draft, Writing - review & editing.
Funding
This paper was supported by Fund of Biomedical Research Institute, Jeonbuk National University Hospital.
Conflict of Interest
The authors have indicated they have no potential conflicts of interest to diclosure.
Acknowledgments
We thank all clinical staff at our hospital for their dedication to patient care.