Herpetic Pharyngotonsillitis in an Immunocompetent Adult Male

Background: Herpetic pharyngotonsillitis is a rare clinical entity, especially in immunocompetent adults.While herpes simplex virus (HSV) type I is commonly associated with oropharyngeal infections, HSV type II is infrequently reported as a causative agent.Case presentation: A 30-year-old immunocompetent male presenting with acute sore throat and whitish membranous pharyngotonsillitis without initial vesicular lesions.Initial antibiotic treatment failed to improve symptoms.Further investigation revealed HSV type II via polymerase chain reaction (PCR) analysis.The patient was successfully treated with oral acyclovir, with complete resolution of symptoms.Discussion: Herpes simplex virus pharyngotonsillitis mimics bacterial tonsillitis and may result in misdiagnosis and inappropriate antibiotic use.Molecular diagnostics such as PCR are essential for accurate diagnosis in atypical cases.Although HSV type II is commonly associated with genital infections, it can also present with pharyngeal manifestations due to orogenital transmission.Conclusion: Clinicians should consider HSV, including HSV type II, in the differential diagnosis of pharyngotonsillitis, particularly in cases unresponsive to antibiotics.Early antiviral treatment can accelerate recovery and reduce transmission.