Pathology · single question
Which virus is classically known to mimic the clinical presentation of irreversible pulpitis (tooth pain) before its characteristic vesicular rash appears?
Show answer and explanation
Correct answer: A. Varicella-zoster virus (VZV), via trigeminal nerve branch involvement preceding the visible zoster rash
When herpes zoster reactivates along a trigeminal nerve branch (maxillary or mandibular division), patients can experience severe, well-localized dental pain mimicking pulpitis or odontogenic pain for several days BEFORE the characteristic unilateral vesicular rash appears, making it a recognized diagnostic pitfall — clinicians have occasionally performed unnecessary endodontic treatment on a tooth before the true zoster diagnosis became apparent.