Crimson-colored tongue in adults and children: what means, causes

The presence of a particular disease is often indicated by a change in the normal color of the tongue, and a crimson tongue (red-purple or pink-red) is also an important diagnostic sign.

By the way, there are still no uniform criteria for determining the color of the tongue, and in traditional Japanese medicine (Kampo medicine), when determining diseases, they distinguished between pale, pale red, red, crimson and purple tongue colors, although there are many more “color options”...

Causes crimson tongue

Why can a tongue acquire such a color, that is, is a raspberry tongue a symptom of what disease?

!!!If a diffusely reddened and swollen raspberry tongue in a child (foreign pediatricians call it strawberry) is observed a few days after fever, sore throat and the appearance of a rough rash (first on the neck and chest, and then on the whole body), then this is scarlet fever, caused by beta-hemolytic streptococcus group A (Streptococcus pyogenes). In this case, in the first three days of the disease, the tongue is covered with a thick white coating, which soon disappears, and hypertrophied receptor papillae are clearly visible on the raspberry-colored tongue. What other symptoms are observed with this disease, read in the publication - Scarlet fever in children.

Streptococcal inflammation of the pharynx (pharyngitis) and tonsillitis (tonsillitis) are manifested not only by a sore throat. Symptoms such as diffuse redness of all structures in the pharynx and the mucous membrane of its back wall are observed - a burning pharynx, a raspberry tongue may be covered with a coating (dirty white). [ 1 ]

Pulmonologists often observe a raspberry tongue in pneumonia (staphylococcal or streptococcal).

Raspberry tongue, rash and temperature (up to +38-40°C) appear with such a sapronotic infectious disease as pseudotuberculosis or extraintestinal yersiniosis, which is caused by rodent-borne yersinia (Yersinia pseudotuberculosis). In the scarlet fever form of this disease, symptoms such as fever are noted; small red rash on the body (especially dense in the folds of the skin); hyperemia of the extremities, neck, face, tonsils and a bright raspberry tongue; headache.

The manifestations of Kawasaki disease, an idiopathic mucocutaneous lymphonodular syndrome that affects young children, and multisystem inflammatory syndrome in children are similar in many ways.

Pernicious anemia, which develops due to a deficiency of cyanocobalamin (vitamin B12) in the body, is manifested by a lack of appetite, discomfort in the epigastric region and an enlarged spleen; its classic symptom is a raspberry-varnished tongue (with atrophy of the papillae on its dorsal surface), as well as a raspberry tongue and burning (glossodynia) with paresthesia of the tongue (glossalgia).

Raspberry lips and a varnished raspberry tongue in cirrhosis - a chronic liver disease with the transformation of most of its parenchyma into scar and connective tissue - are considered by experts to be specific symptoms that appear as the disease progresses. In this case, a raspberry liver tongue is combined with symptoms such as palmar and plantar erythema (pronounced redness of the palms and feet), telangiectasia - small clusters of small blood vessels showing through the skin, as well as yellowing of the skin and mucous membranes (due to the accumulation of bilirubin).

Also, atrophy of the papillae of the tongue with its raspberry color can be one of the symptoms of inflammation of the colon - nonspecific ulcerative colitis, stomach cancer, pancreatic glucagonoma.

A raspberry tongue in an adult often occurs with stomach diseases. Thus, a raspberry tongue with a white coating on its back is a sign of gastritis or gastric ulcer caused by Helicobacter pylori. If the raspberry tongue is cracked, then the gastritis is hyperacid - with increased acidity of gastric juice. Also, with gastritis, only the tip of the tongue may be raspberry-colored.

A raspberry spot on the tongue appears not only as a result of damage to the upper gastrointestinal tract, but can also be a sign of erythroplakia of the oral cavity.

Among the symptoms of severe poisoning (mushrooms, heavy metal salts), toxic shock syndrome in some bacterial infections, and chronic renal failure, doctors note a dark crimson tongue.

Raspberry tongue in older people is associated with several causes. Firstly, it is a lack of proteins and B vitamins (thiamine, riboflavin, pyridoxine) in the diet; secondly, it is glossitis caused by wearing dentures; thirdly, it is idiopathic varicose veins on the underside of the tongue. At the same time, raspberry tongue and dry mouth (xerostomia) with a burning sensation in the mouth and decreased sensitivity of taste buds can be caused by obstruction of the salivary ducts during inflammation of the salivary glands (sialadenitis). [ 2 ]

Finally, a change in the color of the tongue and oral mucosa - in the form of the development of lichen planus - is possible in response to the action of certain chemicals on the body, including medications. For example, a raspberry tongue after antibiotics (especially the tetracycline group) is one of their possible side effects.

Pathogenesis

The extensive capillary network of the tongue in its superficial layers is connected with receptor papillae. The pathogenesis of such a symptom as reddening of the tongue or its acquisition of a raspberry color in the presence of an infection is caused by a reaction to the entry of bacterial toxins into the blood, leading to the expansion of capillaries and blood flow. [ 3 ]

In diseases of other etiologies, there is activation of cytokines, macrophages, neutrophils, and lymphocytes responsible for vasodilation of mediators, which leads to dilation of blood vessels, increased permeability of their walls, and diapedesis – leakage of red blood cells and other elements into the intravascular space.

Diagnostics crimson tongue

Given the presence of such a symptom as a raspberry tongue, diagnostics, including differential diagnostics, should determine the cause of the appearance of this symptom.

In cases of scarlet fever in children, pediatricians usually have no difficulty.

In other cases, the examination includes an examination of the oral cavity, blood tests (general and biochemical, enzyme immunoassay for antibodies, for vitamin B12 levels, for sugar levels, etc.); urine and stool tests. If necessary, a swab is taken from the throat and a throat examination is performed. [ 4 ]

Instrumental diagnostics are carried out using laryngoscopy, pharyngoscopy, ultrasound of the gastrointestinal tract, echosonography of the liver, etc.

Treatment crimson tongue

While it is possible to treat clinical symptoms such as cough, pain or fever, it is not possible to treat raspberry tongue separately from the underlying disease.

For example, the main drugs used for streptococcal sore throat are: Amoxicillin, Erythromycin and first-generation cephalosporins.

Read more:

• What antibiotics should be taken for scarlet fever and how long should they be taken?
• Treatment of pseudo tuberculosis
• Treatment of tonsillitis and acute pharyngitis
• Antibiotics for tonsillitis
• Antibacterial drugs for the treatment of pneumonia
• Treatment of glossitis
• Treatment of gastritis with high acidity

Where possible, your doctor will recommend additional herbal treatment (depending on the condition).

Complications and consequences

Complications of such a symptom as a crimson tongue have not been observed by doctors, but the consequences of the same scarlet fever can include: ear infections, pharyngeal abscess, sinusitis, pneumonia, meningitis, rheumatic fever, renal or heart failure.

Late complications of Kawasaki disease can develop in adults in the form of acute coronary syndromes.

Erythroplakia is prone to malignancy, which results in oral cancer.

Prevention

As you understand, it is impossible to prevent the symptom, but measures to reduce the risk of some diseases can be taken. For example, prevention of pseudo-tuberculosis consists of fighting rodents and observing sanitary rules when processing food products and storing them.

Forecast

Treatment of the disease leads to the disappearance of its symptoms, including such as raspberry tongue.