Differential Diagnosis for the 30-year-old Male
- Single most likely diagnosis
- Herpes Simplex Virus (HSV) infection: The patient's history of HSV 1, recent intimate relations with a partner who has a history of HSV 1 and 2 and was experiencing a flareup, and the presence of sores on his lip and tongue make this diagnosis highly likely.
- Other Likely diagnoses
- Traumatic oral ulcers: The patient reports biting his cheek and tongue when chewing, which could cause traumatic ulcers that may resemble HSV sores.
- Aphthous ulcers: These are common, recurrent, and painful ulcers that can appear on the tongue, lips, and inside of the mouth, and may be mistaken for HSV sores.
- Hand, Foot, and Mouth Disease (HFMD): Although less common in adults, HFMD can cause sores on the tongue and lips, and the patient's recent exposure to someone with a viral infection could be a contributing factor.
- Do Not Miss diagnoses
- Oral cancer: Although unlikely, oral cancer can present with ulcers or sores on the lips or tongue, and it is essential to rule out this diagnosis, especially if the sores do not heal or worsen over time.
- Syphilis: The patient's history of intimate relations with someone who has a history of HSV increases his risk of other sexually transmitted infections, including syphilis, which can cause oral ulcers.
- Human Immunodeficiency Virus (HIV) infection: The patient's exposure to someone with a history of HSV and his own history of HSV 1 increase his risk of HIV infection, which can cause oral ulcers and other symptoms.
- Rare diagnoses
- Behçet's disease: A rare autoimmune disorder that can cause recurrent oral ulcers, as well as other symptoms such as genital ulcers and eye inflammation.
- Erythema multiforme: A rare skin condition that can cause oral ulcers, as well as other symptoms such as skin lesions and eye inflammation.
- Autoimmune disorders (e.g., lupus, rheumatoid arthritis): These conditions can cause oral ulcers, although they are less common and would typically be accompanied by other systemic symptoms.