Oral cavity & oropharynx



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Cite this page: DeVilliers P, Thakral C, Pernick N. Infections-general. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityinfectionsgeneral.html. Accessed December 6th, 2021.
Candidiasis (thrush)
Definition / general

Case reports

Clinical images

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on palate

White plaques and reddened regions of tongue

Retrocommissural area


Angular cheilitis

Gross description
  • Superficial curdy, gray-white membranes that easily wipe off (pseudomembranous candidiasis) or painful erosions (erythematous candidiasis)

Microscopic (histologic) description
  • PAS+ hyphae within keratin layer in neutrophilic background; prominent inflammatory infiltrate along the lamina propria

Microscopic (histologic) images

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Candidal hyphae

Herpes simplex virus
Definition / general
  • Also called cold sore
  • Usually HSV1
  • Lasts 3 - 4 weeks, then virus tracks along regional nerves and becomes dormant in trigeminal or other local ganglia
  • Most infected adults have latent HSV1 that is activated by upper respiratory infection, excessive exposure to cold, wind, sun, allergies
  • Acute herpetic gingivostomatitis:
    • Rare, children 2 - 4 years with diffuse involvement of oral and pharyngeal mucosa, tongue, gingiva
    • Fiery red mucosa and swelling with clusters of vesicles
  • Recurrent herpetic stomatitis:
    • Groups of 1 - 3 mm vesicles on the lips, nasal orifices, buccal mucosa
    • Lesions heal in 7 - 10 days
  • Tzanck test: microscopic examination of vesicle fluid shows giant cells, inclusions

Gross description
  • Vesicles or bullae with clear serous fluid, painful shallow ulcers

Microscopic (histologic) description
  • Intra and intercellular edema (acantholysis), intranuclear inclusions, multinucleate polykaryons (giant cells)
Herpes simplex / zoster
Infectious mononucleosis
Definition / general
  • Acute pharyngitis and tonsillitis with gray-white exudate, lymphadenopathy in neck
  • Due to Epstein-Barr virus infection

Microscopic (histologic) description
  • Tonsil: reactive lymphoid hyperplasia (polymorphous transformed lymphocytes) with extensive immunoblastic proliferation in sheets and nodules, marked atypia resembling Reed-Sternberg cells (Am J Surg Pathol 1987;11:122)

Microscopic (histologic) images

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Peripheral blood lymphocytosis

Reactive lymphocytes

Negative stains
Verruca vulgaris
Definition / general
  • Associated with HPV

Microscopic (histologic) description
  • Cup shaped margins, prominent hyperkeratinized spires

Microscopic (histologic) images

Contributed by Joseph Christopher Castillo, M.D.

Oral cavity

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