Recurrent Aphthous Stomatitis
I am a 35-year-old male, weighing 229 pounds and standing at 6 feet 5 inches. A couple of years back, I found myself in the hospital due to a high fever accompanied by a swollen, bleeding tongue, and multiple herpes sores present throughout my mouth and throat. Following treatment with aciclovir and a negative HIV test result, I was diagnosed with aphthous stomatitis. Lately, I’ve been experiencing persistent fatigue and feelings of exhaustion. Since the start of the year, I have noticed the resurgence of several white spots on the hard palate. Additionally, there's a new lesion developing behind my teeth. Some spots have healed intermittently over the months but seem to remain in a dormant state, with a few appearing larger than in the past. My physician appears unconcerned; despite my reminders about my past hospitalization, he prescribed Zostex, which seems intended for a different type of herpes (zoster?). Shouldn’t aciclovir be the recommended treatment for this condition? Currently, only one area shows active symptoms, but I’m worried about the potential for this issue to persist or worsen. What steps should I take to address this?
Answers (1)

8/25/2025, 4:51:45 PM
OpenHealth AI
Persistent oral lesions and fatigue, especially considering your past hospitalization due to severe symptoms, can understandably raise concerns. Here are some key points and steps to consider.
Main Points:
- Recurrent aphthous stomatitis (canker sores) can cause white spots and lesions in the mouth.
- Fatigue and the recent changes in your lesions may warrant further consideration.
- Treatment options can vary, and it's important to discuss your concerns.
Explanation:
Aphthous stomatitis is characterized by painful sores in the mouth that can recur, and while it typically is not caused by a viral infection, certain factors like stress, immune responses, dietary deficiencies (like vitamin B12, folate, or iron), or underlying health issues can contribute to its development.
Your experience with symptoms such as fatigue and the appearance of new lesions is concerning, especially with the history of a severe episode. Zostex (which contains valacyclovir) is typically prescribed for herpes zoster (shingles) and may not directly address your current symptoms related to aphthous stomatitis. It's essential to carefully monitor these lesions and their changes.
Next Steps:
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Symptom Monitoring: Keep a detailed diary of your symptoms, noting when new lesions appear, how long they last, and any patterns related to diet, stress, or any new medications.
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Self-Care Practices:
- Maintain oral hygiene by gently brushing your teeth and using mild mouthwashes.
- Consider using topical treatments like corticosteroid ointments or over-the-counter oral analgesics to help manage pain and inflammation.
- Stay hydrated and maintain a balanced diet rich in vitamins and minerals to support your immune system.
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Lifestyle Considerations:
- Identify and reduce stress where possible, as stress can trigger outbreaks.
- Assess your diet for potential deficiencies in B vitamins, iron, or folate. If needed, consider supplements but check with a health professional for guidance specific to your case.
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Follow-Up: Given your history and current symptoms, consider scheduling a follow-up appointment with your healthcare provider. Express your concerns about the change in lesions and fatigue; this may prompt further evaluation or a referral to an oral specialist if necessary.
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Raise Concerns: If your symptoms worsen or if you develop new concerning signs (like increased swelling, bleeding, or persistent lesions), it’s important to communicate these to your doctor actively. Advocate for further investigation, especially if your fatigue persists.
Remember, while recurrent lesions can be frustrating and concerning, with the right self-care and monitoring, you can manage symptoms effectively. Don't hesitate to reach out for more personalized guidance or support.
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