# Acute-onset stomatitis in a young European woman visiting Brazil: a case report

## TL;DR

A young European woman developed severe mouth sores after visiting Brazil, likely from a virus, showing the difficulty in diagnosing such infections in travelers.

## Contribution

Highlights diagnostic challenges of viral stomatitis in adult travelers and the risks of empirical corticosteroid treatment.

## Key findings

- Symptoms resolved in ten days with supportive care but worsened before improvement.
- No definitive diagnosis due to lack of virological testing.
- Case emphasizes the need for better diagnostic tools and clinician awareness of viral oral infections.

## Abstract

We report a case of acute, severe stomatitis in a 20-year-old European woman shortly after her arrival in Brazil following participation in a multi-day carnival. The clinical picture was consistent with either primary herpes simplex virus type 1 (HSV-1) infection or herpangina caused by enteroviruses. Due to the absence of virological testing, a definitive diagnosis was not established. Empirical treatment with corticosteroids and antibiotics was initiated, while antiviral therapy was omitted. The patient's symptoms progressed significantly before resolving with supportive care within ten days. This case underscores the diagnostic challenges of viral oral infections in adults, especially in travelers exposed to novel pathogens. It highlights the importance of bedside diagnostic tools, the potential risks associated with empirical corticosteroid use, and the need to enhance clinician awareness of viral stomatitis as a significant and potentially debilitating condition in adult patients.