Crimson tongue in adults and children: what does it mean, causes

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

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, pale, pale red, red, crimson and purple colors of the tongue were distinguished, although there are much more “color options”...

Causes raspberry tongue

Why can a tongue acquire such a color, that is, a crimson tongue is 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 a fever, sore throat and the appearance of a rough rash (first on the neck and chest, and then on the whole body), then this  scarlet fever caused by group A beta-hemolytic streptococcus (Streptococcus pyogenes). At the same time, in the first three days of the disease, the tongue becomes covered with a thick white bloom, which soon disappears, and hypertrophied receptor papillae are clearly visible on the crimson 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 flaming pharynx, while the raspberry tongue may be coated with a coating (off-white). [1]

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

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

The manifestations of Kawasaki disease  , which affects young children, idiopathic mucocutaneous lymphatic syndrome, and multisystem inflammatory syndrome in children, are largely similar .

Pernicious anemia, which develops with a deficiency in the body of cyanocobalamin (vitamin B12), is manifested by a lack of appetite, unpleasant sensations in the epigastric region and an increase in the size of the spleen; its classic symptom is a crimson lacquered tongue (with atrophy of the papillae on its dorsal surface), as well as a crimson tongue and burning sensation (glossodynia) with paresthesia of the tongue (glossalgia).

Crimson lips and a lacquered crimson tongue for cirrhosis - a chronic lesion of the liver with the transformation of most of its parenchyma into scar and connective tissue - experts attribute to specific symptoms that appear as the disease progresses. At the same time, a raspberry hepatic tongue is combined with symptoms such as palmar and plantar erythema (pronounced redness of the palms and feet), telangiectasia - the translucence of small clusters of small blood vessels 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 crimson color can be one of the symptoms of inflammation of the colon -  ulcerative colitis , stomach cancer,  pancreatic glucagonoma .

An adult often has a raspberry tongue with stomach diseases. So, a raspberry tongue with a white coating on its back is a sign of gastritis or gastric ulcer caused by Helicobacter pylori. If at the same time the crimson tongue is cracked, then the gastritis is hyperacid - with increased acidity of gastric juice. Also, with gastritis, there may be only a crimson tip of the tongue.

And a crimson spot on the tongue appears not only as a result of damage to the upper part of the gastrointestinal tract, but can be a sign of  oral erythroplakia .

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

Raspberry tongue in the elderly has been linked to several causes. First, there is a lack of proteins and B vitamins (thiamine, riboflavin, pyridoxine) in the diet; secondly, it is glossitis caused by wearing dentures  ; third, idiopathic varicose veins on the lower surface of the tongue. At the same time, a raspberry tongue and dry mouth (xerostomia) with a burning sensation in the mouth and a decrease in the sensitivity of taste buds can be caused by obstruction of the salivary ducts with inflammation of the salivary glands (sialadenitis). [2]

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

Pathogenesis

The branched capillary network of the tongue in its surface layers is connected with the receptor papillae. The pathogenesis of a symptom such as redness of the tongue or its acquisition of a crimson color in the presence of an infection is due to a reaction to the ingress of bacteria toxins into the bloodstream, leading to expansion of capillaries and blood flow. [3]

In diseases of a different etiology, cytokines, macrophages, neutrophils, lymphocytes are activated, which are responsible for the vasodilation of mediators, which leads to the expansion of blood vessels, an increase in the permeability of their walls and diapedesis - the leakage of erythrocytes of blood and its other elements into the intravascular space.

Diagnostics raspberry 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, as a rule, have no difficulty.

In other cases, the examination includes examination of the oral cavity, blood tests (general and biochemical, enzyme immunoassay for antibodies, for the level of vitamin B12, for the level of sugar, etc.); analyzes of urine and feces. If necessary, a pharyngeal swab is taken and the pharynx is  examined . [4]

Instrumental diagnostics is carried out using laryngoscopy, pharyngoscopy,  ultrasound of the gastrointestinal tract , liver echo sonography, etc.

Treatment raspberry tongue

If clinical symptoms such as cough, pain, or fever can be treated, then treating a raspberry tongue separately from the underlying disease is not possible.

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

Read more:

• What and how much to drink antibiotics for scarlet fever?
• Treatment of pseudotuberculosis
• Treatment of angina and acute pharyngitis
• Antibiotics for tonsillitis
• Antibacterial drugs for pneumonia
• Glossitis treatment
• Treatment of gastritis with high acidity

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

Complications and consequences

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

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

Erythroplakia is prone to malignancy, the consequence of which is oral cancer.

Prevention

As you can imagine, it is impossible to prevent a symptom, but you can take measures to reduce the risk of some diseases. For example, the prevention of pseudotuberculosis consists in the fight against rodents and the observance of sanitary rules during food processing and storage.

Forecast

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