What Is Strawberry Tongue A Symptom Of?
Strawberry tongue is the symptom found in very few diseases such as bacterial and viral infections, allergic reactions and Kawasaki disease. Strawberry tongue is caused due to the desquamation of the epithelium of the tongue leading to the exposure of the underlying layer. Presence of excess inflammatory mediator is the primary reason behind the strawberry tongue. (1)
Kawasaki disease has no characteristic symptoms; thus, the diagnosis is hard. However, certain symptoms give a clue about the disease and strawberry tongue is one of them.
Various disorders, especially the disease of the blood or the buccal disease, the morphology of the tongue gets altered. The alterations of the tongue include the geographical tongue, strawberry tongue and balding. Various conditions alter the morphological characteristics of drugs such as viral and bacterial infection, anemia, and deficiency of essential vitamins such as Vitamin B12 and folic acid. Further, the diseases which can alter the tongue are psoriasis and Kawasaki disease.
Strawberry tongue means the tongue resembles the strawberry skin. The various diseases lead to the formation of a strawberry tongue. These include bacterial and viral infections as well as non-infective reasons. The bacterial infections which present the symptoms of the strawberry tongue are toxic shock syndrome, Yersinia pseudotuberculosis, and scarlet fever.
The viral infection responsible for the strawberry tongue is yellow fever. However, if the infective conditions are excluded, the strawberry tongue is one of the important conclusive diagnoses for Kawasaki disease.
The condition is characterized by hyperemia along with the protruded and inflamed papillae. It is present on the dorsum surface of the tongue. Sometimes it may also occur due to allergic reactions initiated by food or medicine.
Cause Of Strawberry Tongue
Kawasaki disease is characterized by the presence of acute inflammation all over the body. This is similar to the toxin-mediated inflammation as seen in various bacterial as well as viral infections. The primary reason for the development of the strawberry tongue is the presence of high level of inflammatory mediators within the body. A keratinized epithelium is present on the filiform papillae. High level of inflammatory mediators in the patients with Kawasaki disease may lead to the desquamation of this keratinized epithelium. This leads to the exposure of the underlying surface with inflammation and the filiform papillae get hypertrophic leading to the presentation of strawberry seed-like structures. The strawberry tongue is seen in the initial acute phase of the disease along with cardiac complications.
Symptoms Of Kawasaki Disease
Kawasaki disease is hard to diagnose, and the diagnosis is generally done through the exclusionary process. This is due to the fact that it does not have any characteristic diagnostic symptom and also the cause of the condition remains unknown. The symptoms of the Kawasaki disease depend upon the phase in which the patient is present. Difference phases have different symptoms.
Phase I (Acute Febrile Phase)
The symptoms of this phase include the increased irritation of the child and there is a sudden appearance of symptoms. The initial symptom of the disease is high fever which is not gets reduced with the antipyretic drugs. The hands and feet of the patient get swollen and are tender to touch. Due to the inflammation of the blood vessels, conjunctivitis becomes red without any pain and secretions. The characteristic strawberry tongue also occurs at this stage. The lymph node gets swollen due to inflammation.
Phase II (Sub-acute Phase)
As the disease progresses from the acute to sub-acute phase, other symptoms began to emerge. The fever disappears however, the irritability exists, and some other symptoms such as diarrhea, vomiting, abdominal pain and distension, joint pain and peeling of the skin appear.
Phase III (Convalescent stage)
This stage is characterized by the disappearance of the symptoms of the disease. The child feels relaxed and the pain from the joints and the abdomen disappears. However, as in the case with the convalescence stage of other diseases, the child will feel tired and have a lack of energy.
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