Differential Diagnosis for Herpes Tongue
- Single Most Likely Diagnosis
- Herpes Simplex Virus (HSV) infection: This is the most likely diagnosis due to the characteristic presentation of painful, shallow ulcers on the tongue, which is a common site for HSV outbreaks.
- Other Likely Diagnoses
- Aphthous ulcers: These are common, recurrent, and often painful ulcers that can appear on the tongue, but they tend to be larger and fewer in number compared to HSV.
- Traumatic ulcers: Accidental bites or other forms of trauma to the tongue can cause ulcers that may resemble those caused by HSV.
- Hand, Foot, and Mouth Disease (HFMD): This viral illness, caused by Coxsackievirus or Enterovirus, can lead to ulcers on the tongue, but it typically presents with additional symptoms like fever and rash on the hands and feet.
- Do Not Miss Diagnoses
- Oral cancer: Although rare, ulcers on the tongue can be a sign of oral cancer, especially if they are persistent, grow in size, or are associated with other symptoms like difficulty swallowing or a lump in the neck.
- Syphilis: Secondary syphilis can cause mucous patches or ulcers in the mouth, including on the tongue, which can be mistaken for HSV.
- Autoimmune disorders (e.g., pemphigus, pemphigoid): These conditions can cause blistering lesions or ulcers in the mouth, including on the tongue, and require prompt diagnosis and treatment to prevent serious complications.
- Rare Diagnoses
- Behçet's disease: A rare autoimmune disorder that can cause recurrent ulcers in the mouth, including on the tongue, as well as genital ulcers and eye inflammation.
- Erythema multiforme: A rare skin condition that can cause ulcers and lesions in the mouth, including on the tongue, often in response to an infection or medication.
- Primary HIV infection: In some cases, primary HIV infection can cause ulcers in the mouth, including on the tongue, as part of an acute retroviral syndrome.