How may primary herpes simplex present?

Primary herpes simplex typically presents as generalized stomatitis, characterized by multiple shallow and painful ulcers in the oral cavity. This can be a result of the body's immune response to the herpes simplex virus (HSV) during initial infection. The ulcers may be accompanied by a red halo and can significantly cause discomfort, leading to difficulties in eating and drinking.

Patients often experience systemic symptoms as the infection progresses, which may involve swollen lymph nodes in conjunction with flu-like symptoms, but these are not the primary manifestation of herpes simplex. Similarly, while some individuals can remain asymptomatic, the question specifically asks about the presentation of primary herpes simplex, which typically involves visible lesions, making asymptomatic cases an inaccurate choice in this context. Lastly, a severe skin rash with fever is more characteristic of infections like varicella (chickenpox) or allergic reactions rather than primary herpes simplex. Therefore, the presentation as generalized stomatitis with painful ulcers aligns well with the expected clinical findings associated with primary herpes simplex infections.