What is the cause of strawberry tongue (glossitis)?

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Last updated: February 23, 2025View editorial policy

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Differential Diagnosis for Strawberry Tongue

  • Single most likely diagnosis
    • Scarlet Fever: This is the most common cause of strawberry tongue, characterized by a bright red tongue with prominent papillae, often accompanied by a sore throat and fever.
  • Other Likely diagnoses
    • Kawasaki Disease: An acute febrile illness that can cause strawberry tongue, along with other symptoms like rash, conjunctivitis, and cervical lymphadenopathy.
    • Toxic Shock Syndrome: A severe condition that can cause strawberry tongue, along with high fever, vomiting, diarrhea, and hypotension.
    • Vitamin Deficiencies (e.g., Vitamin B12, Iron, or Folate deficiency): These deficiencies can cause changes in the tongue's appearance, including a strawberry-like appearance.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Diphtheria: A bacterial infection that can cause a strawberry tongue, along with a membrane covering the tonsils and throat, and can lead to respiratory obstruction if not treated promptly.
    • Stevens-Johnson Syndrome: A severe skin and mucous membrane disorder that can cause strawberry tongue, along with other symptoms like skin blisters and eye inflammation.
  • Rare diagnoses
    • Geographic Tongue: A benign condition that can cause changes in the tongue's surface, including a strawberry-like appearance, but is usually asymptomatic.
    • Median Rhomboid Glossitis: A rare condition that can cause a strawberry-like appearance on the tongue, often accompanied by other oral lesions.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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