5. A 5-year-old girl had a temperature of 102.4°F, a sore throat, and a red tongue with prominent papillae. The posterior pharynx was also erythematous with slight exudate visible. The anterior cervical lymph nodes were mildly tender and somewhat enlarged, and no rashes were noted.
Diagnosis: The child had a strawberry tongue and scarlet fever caused by strep pharyngitis. The tongue had prominent papillae along with erythema, making it resemble a strawberry. Strawberry tongue is most commonly seen in children with scarlet fever or Kawasaki disease. Strawberry tongue usually develops within the first 2 to 3 days of illness. A white or yellowish coating usually precedes the classic red tongue with white papillae.
For more information, read “Papillae on tongue.” J Fam Pract. 2014.