RT Book, Section
A1 Jauch, Edward C.
A1 Valdez, J. Amadeo
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181040725
T1 Strawberry Tongue
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181040725
RD 2024/04/19
AB Reddened  hypertrophied  lingual  papillae,  called  strawberry  tongue,  are  primarily  associated  with  scarlet  fever  caused  by  group  A  streptococcal  enterotoxin.  The  tongue  initially  appears  white  with  the  erythematous  papillae  sticking  through  the  white  exudate.  After  several  days,  the  white  coating  is  lost  and  the  tongue  appears  bright  red.  Other  signs  of  group  A  streptococcal  infection  include  fever,  an  exudative  pharyngitis,  a  scarlatiniform  rash,  and  the  presence  of  Pastia  lines  (petechial  linear  rash  in  the  skin  folds).  Kawasaki  syndrome  may  also  present  with  an  injected  pharynx  and  an  erythematous  strawberry-like  tongue.  It  is  essential  to  make  the  distinction  between  streptococcal  infection  and  Kawasaki  syndrome,  since  the  latter  is  associated  with  a  high  incidence  of  coronary  artery  aneurysm  if  left  untreated.  Also  important  to  consider  is  toxic  shock  syndrome,  in  which  one-half  to  three-fourths  of  patients  have  pharyngitis  with  a  strawberry-red  tongue.