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Case 3: Aphthous Stomatitis

You answered:

C The diagnosis of aphthous stomatitis is best made by performing a Gram’s stain and observing multiple gram-positive rods lining the surface of mucosal cells.

This answer is incorrect. The diagnosis of aphthous stomatitis is typically a diagnosis of exclusion. Herpes simplex virus infection should be ruled out, as was done with this patient. There is no evidence that Gram’s stain provides useful information for diagnosing aphthous stomatitis.

A Cytomegalovirus infection has been identified as the cause of aphthous stomatitis.
B Thalidomide (Thalomid) is an effective therapy for aphthous stomatitis.
D Oral valganciclovir (Valcyte) is an effective therapy for aphthous stomatitis, providing an approximate 85% clinical response rate.

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