Pyogenic granuloma of the tongue coinfected with cytomegalovirus in an immunocompromised patient: a case report

Cytomegalovirus (CMV) is an opportunistic infection that can lead to organ rejection in transplant recipients. In the oral cavity, it usually appears as nonhealing ulcers. For an accurate diagnosis, tissue biopsy has to be performed, and the antiviral drug of choice is ganciclovir. A 9-year-old female patient with a history of heart transplant 3 months prior was receiving prednisone and tacrolimus. Clinical examination revealed a soft, nontender, pink, pedunculated, and ulcerated covered with pseudomembrane mass of the right lateral border of the tongue with a history of trauma during intubation 2 months prior. Excisional biopsy was performed, and anatomopathologic evaluation revealed pyogenic granuloma and CMV infection. The patient was admitted to the hospital for ganciclovir treatment. Prior to the transplant, the patient was CMV(−) and the donor was CMV(+). Although the most common oral CMV manifestation in immunosuppressed patients are nonhealing ulcers, we report the first literature case of oral pyogenic granuloma coinfected with CMV.