'Herpes simplex virus infection in a bipulmonary transplant recipient'.

This case reports a 45-year-old man with a history of bilateral lung transplantation for cystic fibrosis, on immunosuppressive therapy with tacrolimus and mycophenolate, presented with odynophagia. Examination showed painful ulcer clusters across the tongue, without oropharyngeal or systemic involvement. Labs and imaging were unremarkable. He had recently been hospitalized for pneumococcal pneumonia. PCR of vesicular fluid confirmed HSV-1 infection. Treatment with valacyclovir 500 mg twice daily for 7 days led to complete resolution, with no recurrence at 6 months.HSV may present atypically in immunocompromised patients; lingual involvement, though rare, should be considered in transplant recipients with clustered oral ulcers.