Differential Diagnosis for Back of Tongue White and Difficulty Swallowing
Single Most Likely Diagnosis
- Oral Thrush: This is a fungal infection that can cause white patches on the tongue, including the back, and difficulty swallowing due to the discomfort and inflammation it causes. It's common in immunocompromised individuals, those with poor oral hygiene, or after a course of antibiotics.
Other Likely Diagnoses
- Leukoplakia: A condition where thick, white patches or lesions develop on the tongue, often related to chronic irritation or tobacco use. It can cause discomfort and difficulty swallowing if the lesions are large or numerous.
- Lichen Planus: An autoimmune condition that can affect the mucous membranes inside the mouth, leading to white, lacy patches and sometimes causing difficulty swallowing due to pain or discomfort.
- Tongue Cancer: Though less common, cancer of the tongue can present with white patches or lesions, especially if related to leukoplakia, and can cause difficulty swallowing as the tumor grows.
Do Not Miss Diagnoses
- Epiglottitis: An acute inflammation of the epiglottis that can cause severe difficulty swallowing and is a medical emergency. While it might not directly cause white patches on the back of the tongue, the severe swelling can push the tongue back and cause it to appear abnormal.
- Angioedema: A condition characterized by rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues. It can cause the tongue and throat to swell, leading to difficulty swallowing, and is a medical emergency.
Rare Diagnoses
- Sjögren's Syndrome: An autoimmune disorder that can cause dry mouth and tongue, potentially leading to secondary infections like oral thrush, which could present with white patches on the tongue.
- Pemphigus Vulgaris: A rare autoimmune disease causing blistering of the skin and mucous membranes, which can lead to difficulty swallowing and might present with white patches or lesions on the tongue due to secondary infection or healing blisters.