Differential Diagnosis for a 2-Month-Old Breastfed Girl with a White Tongue
- Single Most Likely Diagnosis
- Oral Thrush: This is the most likely diagnosis due to the age of the patient and the presentation of a white tongue. Oral thrush is a common fungal infection in infants, especially those who are breastfed, caused by Candida albicans. It typically presents with white patches on the tongue and mucous membranes.
- Other Likely Diagnoses
- Milk Residue: Breastfed infants often have a white coating on their tongue due to milk residue, which can be mistaken for oral thrush. This is a common and benign condition.
- Normal Variation: Some infants may have a white tongue due to normal variations in oral flora or transient conditions that resolve on their own.
- Do Not Miss Diagnoses
- Congenital Syphilis: Although rare, congenital syphilis can cause a variety of oral manifestations, including a white tongue. It is crucial to consider this diagnosis due to its severe consequences if left untreated.
- Immunodeficiency: Certain immunodeficiencies can predispose infants to opportunistic infections, including oral candidiasis. Identifying an underlying immunodeficiency is critical for appropriate management.
- Rare Diagnoses
- Histoplasmosis: This is a rare fungal infection that can cause oral lesions, including a white tongue, in immunocompromised individuals.
- Leukoplakia: A rare condition characterized by white patches on the mucous membranes, which can be a precursor to more serious conditions. However, it is extremely uncommon in infants.