Abstract
Because of changes in sexual mores, the oral cavity is increasingly becoming the site of primary infection for sexually transmitted diseases. A 28-year-old man who had severe tonsillitis needed hospitalization for parenteral fluid therapy. The tonsils were red and edematous without lacunar exudates. There was a shallow ulcerative lesion on the right posterior pillar. He had engaged in orogenital sex (cunnilingus) two weeks previously. Culturing swab from the ulcerative lesion and immunofluorescent technique showed herpes simplex virus type 2. The initial leukocyte count was 6400/mm3 with 56% neutrophils, 23% lymphocytes and 21% monocytes. Interestingly, the serum anti-EB virus titer was elevated during the acute phase (VCA γ-G 1 : 80 initially and1 : 20 in the convalescent phase). It seemed likely that endogenous reactivation of latent EB virus occurred in the tonsillar B-lymphocytes in a heterogenous response to HSV-2. One month later culturing swab from the tonsil was negative and the serum titer of anti-HSV type 2 was 1 : 4.
