# Strawberry Tongue Associated With Epstein-Barr Virus Infection in a Seven-Year-Old Boy: A Case Report

## TL;DR

A 7-year-old boy showed strawberry tongue linked to Epstein-Barr virus infection, not typical causes like Kawasaki disease or scarlet fever.

## Contribution

Expands the known clinical associations of Epstein-Barr virus by linking it to strawberry tongue.

## Key findings

- A strawberry tongue resolved spontaneously in a child with confirmed Epstein-Barr virus infection.
- Common causes like strep throat and Kawasaki disease were ruled out through testing.
- The case suggests EBV should be considered in atypical strawberry tongue presentations.

## Abstract

Strawberry tongue is classically associated with Kawasaki disease and scarlet fever, but it may also occur in other infectious or toxin-mediated conditions. We report a seven-year-old boy who presented with nasal obstruction, a generalized erythematous rash, and a strawberry tongue. He was afebrile and had no lymphadenopathy, hepatosplenomegaly, or pharyngeal exudate. Laboratory tests revealed mild liver enzyme elevation and a negative rapid antigen test for Group A Streptococcus. Serology confirmed primary Epstein-Barr virus (EBV) infection. No treatment was given, and all findings resolved spontaneously within 10 days of presentation. Although a causal relationship cannot be firmly established, careful exclusion of other etiologies supports EBV infection as the most plausible explanation for the development of strawberry tongue. This case highlights that EBV should be considered in the differential diagnosis of strawberry tongue when typical features of more common causes are absent.