Differential Diagnosis for Repeated Oral Ulcer, Painful and Ulcerating on Right Side of the Tongue with Mild Fever
- Single Most Likely Diagnosis
- Recurrent Aphthous Stomatitis (RAS): This condition is characterized by recurrent, painful ulcers on the mucous membranes of the oral cavity, including the tongue. The presence of mild fever can sometimes accompany the onset of ulcers, especially if there is secondary infection. RAS is a common condition and can be triggered by various factors including stress, trauma, and certain foods.
- Other Likely Diagnoses
- Oral Lichen Planus: An autoimmune condition that can cause painful ulcers and lesions in the mouth, including on the tongue. It might be accompanied by mild systemic symptoms like fever in some cases.
- Traumatic Ulcer: If the ulcer is located on the right side of the tongue, it could be due to accidental biting or trauma from a sharp tooth or dental appliance, which can become infected and cause fever.
- Herpes Simplex Virus (HSV) Infection: Although typically associated with vesicular lesions, HSV can cause painful ulcers, especially if the vesicles rupture. Fever can be a part of the initial presentation.
- Do Not Miss Diagnoses
- Squamous Cell Carcinoma: Although less likely, any persistent or recurrent ulcer, especially in adults with risk factors like smoking or alcohol use, should prompt consideration of oral cancer. Early detection is crucial for treatment outcomes.
- Tuberculosis (TB): Oral TB can present with ulcers, and while rare, it's a critical diagnosis not to miss due to its public health implications and the need for specific treatment.
- Syphilis: Secondary syphilis can cause a variety of oral manifestations, including ulcers and mucous patches. Given the potential for serious complications if untreated, syphilis should be considered, especially in sexually active individuals.
- Rare Diagnoses
- Behçet's Disease: A form of vasculitis that can cause recurrent oral ulcers, among other systemic symptoms. It's rare but should be considered in patients with recurrent oral ulcers and other systemic symptoms like genital ulcers or eye inflammation.
- Pemphigus Vulgaris: An autoimmune disease causing blistering of the skin and mucous membranes, which can lead to painful ulcers in the mouth. It's a rare condition but important to diagnose due to its potential severity and need for specific treatment.
- Erythema Multiforme: A skin condition that can also affect the mucous membranes, causing ulcers. It's often triggered by infections or medications and can be accompanied by systemic symptoms like fever.
Each of these diagnoses has a different set of implications for treatment and management, emphasizing the importance of a thorough diagnostic workup.