Blood tests should also be conducted to rule out the possibility RBC or WBC deficiency as the causative factors
Red Blood Cell deficiencies including anemia and sideropenia may often clinically present with apthous ulcers by way of reduced oxygen - resulting in ulcerative degeneration. Assessing the patient for pallor skin, backed by a red blood cell count can rule out this differential.
When considering the likely blood conditions that could be affecting Mr Bush, it is imperative to evaluate his B12 and folic acid blood levels and dietary intake. Their role in the Production and maintenance of new cells and DNA synthesis means in their absence, cell deficiency and reduced RBC production may result.
On the same level WBCs should not be overlooked as a possible co-candidate for Mr. Bush’s recurrent ulcers. Circulating white blood cells serve as the primary defense against infections. Hence, patients with WBC deficiency such as neutropenia, leukemia, myelofibrosis and multiple myelomas are more susceptible to flare ups of dormant viral infections as well as increased chance of primary infections.
The notion that Mr. Bush could possibly be suffering from an immunocompromising condition called for us to question any chance of our patient carrying the human immunodeficiency virus as well as other virus’ such as chicken Pox, herpes zoster and Herpes simplex.
HIV would be quickly dismissed as its typical clinical presentation known as larger deeper version of apthous ulcers, did not correspond to Mr Bush’s comparatively mild lesions. ANUG and ANUP could also be ticked off with no signs of gingival or periodontal diseases of such ferocity. Confirmation can be provided with serology tests denying the presence of the Aids virus and a CD4 count.
It was time to consider the Herpes Simplex virus a very likely cause in Mr. Bush bout of recurring oral ulcers. The HSV is a single stranded DNA of long sequence whose replication takes place mainly...