Nasal herpes simplex virus infection

Abstract

A 37-year-old man with epilepsy presented to the emergency department with a 1-week history of skin changes of the nose that began after being scratched on the nose. A few days after the scratch, he hit the tip of his nose on steel bundles during a seizure. He then developed a headache, and his nose began to swell and develop a black appearance at the tip. He had sought attention at another hospital, where he was prescribed doxycycline due to concern for a skin and soft-tissue infection.