Differential Diagnosis for Sores on Tongue in a Toddler
Single Most Likely Diagnosis
- Recurrent Hand, Foot, and Mouth Disease (HFMD): The toddler had HFMD 1 month ago, and it's possible for the disease to recur, especially if exposed to the virus again. The sores on the tongue could be a manifestation of the recurrence.
Other Likely Diagnoses
- Herpes Simplex Virus (HSV) Infection: HSV can cause oral ulcers, including on the tongue, and is common in toddlers.
- Aphthous Ulcers: Also known as canker sores, these are common in children and can appear on the tongue.
- Trauma: Accidental biting or other forms of trauma to the tongue can cause sores.
- Viral Gingivostomatitis: Caused by viruses such as HSV or coxsackievirus, this condition can lead to sores on the tongue and other parts of the mouth.
Do Not Miss Diagnoses
- Herpangina: Although less common, herpangina is a serious condition that can cause severe pain and difficulty swallowing, and it's essential to rule it out.
- Autoimmune Disorders (e.g., Pemphigus): Although rare in toddlers, autoimmune disorders can cause oral ulcers and are critical to diagnose early.
- Immunodeficiency: Underlying immunodeficiency can predispose to recurrent or severe infections, including those causing oral ulcers.
Rare Diagnoses
- Behçet's Disease: A rare condition that can cause oral ulcers, although it's more common in older children and adults.
- Erythema Multiforme: A rare skin condition that can cause oral ulcers, often in response to an infection or medication.
- Leukemia: Although extremely rare, leukemia can cause oral ulcers and is a diagnosis that should be considered if other symptoms such as fever, fatigue, or weight loss are present.