Swollen Tongue in an Immune-Compromised Host

A 25-year-old man presented to the clinic with a worsening oral thrush and difficulty swallowing for the past 3 weeks (Figure 1). He had been treated with fluconazole and penicillin with no benefit. In addition, he reported having a chronic dry cough. Past medical history was significant for human immunodeficiency virus (HIV) infection, and he was not on antiretroviral therapy (ART).