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What Is Strawberry Tongue?

By Clara Kedrek
Updated: May 17, 2024
Views: 62,582
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Strawberry tongue is a physical exam finding in which the upper surface of a patient’s tongue has a distinct red coloration and a characteristic bumpy appearance because of inflammation of the taste buds. This condition is most closely associated with scarlet fever, a childhood illness that is caused by a certain type of bacteria. Toxic shock syndrome, another bacterial infection, also is associated with this tongue abnormality. Kawasaki's disease is another cause of the symptom. Strawberry tongue should be differentiated from other conditions, such as vitamin deficiencies, that can also cause tongue inflammation.

The appearance of strawberry tongue is characterized by a bright red discoloration of the surface of the tongue. It also is associated with a change in the texture of the tongue; the surface of the tongue becomes bumpier because inflammation increases the size of the tastebuds. Many people describe this finding as a looking like a strawberry because of similarities in color and texture between the tongue and the fruit. This condition must be differentiated, of course, from other causes of tongue staining, such as eating red candy or a red popsicle.

Having this tongue condition is most closely linked to a childhood illness called scarlet fever. This disease is caused by infection of bacteria called Streptococcus pyogenes. People who have scarlet fever also experience symptoms such as fever, chills, a sandpaper-like skin rash and a sore throat. It can be treated with antibiotics.

Other bacterial infections also can be associated with strawberry tongue. One is toxic shock syndrome, a disease that can be caused by the bacterial species Streptoccoccus pyogenes or Staphylococcus aureus. This syndrome can be life-threatening, causing symptoms such as fever, low blood pressure and rash.

Another cause of strawberry tongue in children is Kawasaki syndrome, also known as mucocutaneous lymph node syndrome. It causes additional symptoms such as rash, enlarged lymph nodes, eye inflammation and generalized redness and swelling of the mouth and nose. Recognizing and treating this infection is critical because it can have side effects such as the development of coronary artery aneurysms, which can be fatal.

Some other causes of tongue inflammation can mimic strawberry tongue. For example, vitamin deficiencies such as a lack of dietary vitamin B12 can cause the tongue to become red and inflamed, a condition called glossitis. Vitamin deficiencies typically do not cause inflammation of the taste buds, but they can cause erosion and irritation of the corners of the lips.

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Discussion Comments
By fify — On Jan 28, 2013

I have iron and vitamin B deficiencies. If I forget to take my vitamin and iron supplements, I start getting a red, slightly inflamed tongue.

It was first misdiagnosed as strawberry tongue but the tests my doctor asked for showed that I have vitamin deficiencies. My doctor was surprised because inflammation is usually not seen in these cases. It doesn't get extremely inflamed like it does with strawberry tongue, but it is visibly raised.

The redness goes away completely if I take my supplements regularly.

By candyquilt — On Jan 28, 2013

@donasmrs-- Kawasaki syndrome does usually cause some kind of a skin reaction. Kawasaki syndrome also usually lasts around five days to a week. So I would wait and see if there are any changes in symptoms.

If the fever and strawberry tongue continue for several more days, it could be Kawasaki and you need to get blood work done in that case. If you haven't seen a doctor yet, you certainly should. Even if it's not Kawasaki, there must be an infection and antibiotics will be needed.

By donasmrs — On Jan 28, 2013

My daughter doesn't have a rash or eye inflammation but has had a fever for two days as well as strawberry tongue. Could this be Kawasaki syndrome?

Is it Kawasaki only if all of the symptoms are there?

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