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Herpetic Geometric Glossitis in an Immunocompetent Patient: An Atypical Presentation of Oral Herpes Simplex Virus (HSV) Infection

Year: 2026

Type: article

Abstract: Herpetic geometric glossitis (HGG) is a rare, atypical manifestation of herpes simplex virus type 1 (HSV-1) infection, most commonly reported in immunocompromised individuals. We report a case of a 43-year-old immunocompetent male presenting with edematous heme-crusted lips, fissured tongue, and severe oral pain, leading to significant oral intake limitation and subsequent inpatient admission. Dermatology was consulted for possible Stevens-Johnson syndrome, which was ruled out following evaluation. Clinical findings were consistent with HGG, an uncommon presentation of HSV infection. The patient started empiric antiviral therapy, leading to symptom improvement, and HSV-1 polymerase chain reaction testing returned positive, confirming the diagnosis. This case highlights a rare presentation of HSV-1 in an immunocompetent host and emphasizes the importance of recognizing atypical morphologic variants to guide timely diagnosis and management.

Source: Cureus

DOI: 10.7759/cureus.111663

Authors: Steven T Rivera, Laura A Chachula, Paul S Hahn

Institution: San Antonio Uniformed Services Health Education Consortium

Language: English

Topic: Herpesvirus Infections and Treatments

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7166438310