Herpetic geometric glossitis in a pediatric patient with acute myelogenous leukemia

Herpetic geometric glossitis, a recently described form of lingual herpes simplex virus type 1 (HSV-1) infection, has been reported in 6 human immunodeficiency virus (HIV) patients and 1 cardiac transplant patient who was receiving immunosuppressant therapy. An HIV-seronegative immunocompromised pediatric patient with acute myelogenous leukemia who developed herpetic geometric glossitis is described. Herpetic geometric glossitis can present in both adult and pediatric immunocompromised patients. The symptoms, morphology, laboratory findings and treatment of this infection are summarized. The possible consequences of untreated herpetic glossitis include superinfection and undernourishment. Although previously described patients responded to 1000 mg per day (divided in 5 doses) or oral acyclovir, with complete resolution of fissures, this patient developed herpetic geometric glossitis while receiving acyclovir and required higher doses of oral antiviral therapy (acyclovir, 3000 mg/day divided in 5 doses) to treat his HSV-1 lingual infection. Empiric treatment of an immunocompromised patient who has newly acquired painful tongue fissures or furrows with systemic acyclovir should be considered.