Oral hairy leukoplakia: a manifestation of primary infection with Epstein-Barr virus?

Oral hairy leukoplakia (OHL) is a characteristic lesion presumably secondary to Epstein-Barr virus (EBV) reactivation. It is frequently seen in individuals infected with the human immunodeficiency virus (HIV) and less often in other immunosuppressed individuals. The frequent association of this lesion with HIV infection and its rare occurrence in normal individuals usually motivates the search for immunosuppression, particularly secondary to HIV, when this lesion is found. We describe here a healthy HIV-negative individual with OHL and clinical and laboratory data suggestive of acute EBV infection.