Tongue ulcer in a patient with COVID-19: a case presentation

Abstract

Background The emergence of COVID-19 has devastated many parts of the world. From asymptomatic to symptomatic, the virus causes a wide spectrum of presentations. COVID-19 patients may present with oral manifestations. In Afghanistan, where COVID-19 has severely strained the health care system, much of the population lacks proper oral hygiene. This makes the oral cavity a perfect site for SARS-CoV-2 to manifest clinical signs. Case presentation A 62-year-old male was evaluated in the Dentistry Teaching Clinic of Kabul University of Medical Sciences for a painful erosive lesion on dorsal surface of his tongue. He also complained of fever, cough, and taste alteration. He was referred to Afghan Japan Hospital for COVID-19 testing and tested positive. He was followed on for the treatment of SARS-CoV2. After 2 weeks, the patient tested negative and returned to the dentistry clinic for follow-up. Although there were no other signs of COVID-19, the painful erosive lesion on his tongue persisted. Oral evaluation were performed and the patient was advised to practice good hygiene. After 10 days, we observed an asymptomatic geographic tongue without fever and myalgias and the lesion of dorsal surface of tongue improved from severe condition to moderate. Conclusion In conclusion, patients with suspected or confirmed SARS-CoV-2 should be screened for symptoms and physical findings in the oral mucosa To prevent such an outcome, awareness programs need to be implemented for the diagnosis and management of clinical symptoms among patients.

Myocarditis and Subclinical-Like Infection Associated With SARS-CoV-2 in Two Cats Living in the Same Household in France: A Case Report With Literature Review

“…In the present report, a large ulcer was also found on Cat-1's tongue base at the time of presentation, which may have contributed to inappetence. Various oral manifestations of COVID-19 have been reported in human patients, including dry mouth, gustatory impairment, gingivitis, sialadenitis, vesicular and ulcerative mucosal lesions predominantly located on dorsal surface of the tongue (as in our case), hard palate, and labial mucosa (45)(46)(47). The exact pathogenesis of such oral signs remains uncertain, probably involving several mechanisms, such as deterioration of the general health status, hypersensitivity of drugs used for COVID-19 treatment, stress, immunosuppression, vasculitis, and hyper-inflammatory response secondary to SARS CoV-2 infection as predisposing factors (45)(46)(47).…”

“…Various oral manifestations of COVID-19 have been reported in human patients, including dry mouth, gustatory impairment, gingivitis, sialadenitis, vesicular and ulcerative mucosal lesions predominantly located on dorsal surface of the tongue (as in our case), hard palate, and labial mucosa (45)(46)(47). The exact pathogenesis of such oral signs remains uncertain, probably involving several mechanisms, such as deterioration of the general health status, hypersensitivity of drugs used for COVID-19 treatment, stress, immunosuppression, vasculitis, and hyper-inflammatory response secondary to SARS CoV-2 infection as predisposing factors (45)(46)(47). In addition, high expression of ACE2, recognized as the SARS-CoV-2 entry ligand receptor, has been reported in cells of the oral cavity, predominantly in epithelial cells of the tongue, and in buccal and gingival tissues at a lesser extent, thus predisposing to oral SARS-CoV-2 infection with a local virus effect (48).…”

Oral mucosa lesions in confirmed and non-vaccinated cases for COVID-19: A systematic review

“…The other lesions reported were diffuse erythema diagnosed as mucositis ( 14/116; 12 %);[ 6 , 22 ] angina bullosa haemorrhagic-like and associated vascular disorder ( 5/116; 4.3 %) [23] ; petechiae ( 2/116; 1.7 %)[ 24 , 25 ] white plaque reported as candidiasis ( 5/116; 4.3 %). 16,17 Tumoral lesion ( 2/116; 1.7 %)[ 26 , 27 ] were also reported, being one case related to a Melkersson-Rosenthal syndrome [27] , which is characterized by recurrent orofacial edema, fissures in the tongue and peripheric facial paralysis and commissural fissures on lips.…”

The Oral Complications of COVID-19

“…Oral complications can result from improper medication use, weakened immunity, vascular damage, local and systemic inflammation, and neglect of oral hygiene during COVID-19 treatment ( Botros et al, 2020 ; Iranmanesh et al, 2021 ). For patients with COVID-19, the oral signs and symptoms should be paid more attention during the treatment, including taste disorders, pechymosis, Candidiasis, traumatic ulcers, HSV-1 infection, geographic tongue, thrush, etc ( Arastehfar et al, 2020 ; Xu et al, 2020b ; Nejabi et al, 2021 ). A multidisciplinary approach to oral health care and clinical oral examinations for COVID-19 patients will be benefit for the treatment and recovery.…”