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Parenting is full of all sorts of challenges, including figuring out what’s wrong with your children when they’re sick. That difficulty is compounded when very young children aren’t able to communicate what’s wrong or don’t understand what being sick means. So you have to look for symptoms. But some oral symptoms might not be so obvious, such as bumps on a tongue.

What Is Strawberry Tongue?

This term refers to a tongue that is swollen, bumpy and bright red, resembling a strawberry. It generally occurs in children and is a symptom of another medical condition, like scarlet fever.

For example, this swollen, red tongue may indicate allergies or a vitamin deficiency. If it results from a food or medication allergy, your child might also have itchy, watery eyes, a scratchy mouth and a rash. Low levels of vitamin B-12 and folate will be accompanied by weakness and fatigue, balance issues and memory complications.

But a tongue that resembles a strawberry can also be a sign of two more serious diseases: Kawasaki disease and scarlet fever.

Kawasaki Disease

Kawasaki disease (KD) is a serious condition marked by inflamed blood vessels throughout the body, according to the Kawasaki Disease Foundation. The disease is a cause of heart disease in children. It is diagnosed mostly in the winter and early spring. Eighty percent of cases occur in children younger than 5 years of age, and it’s more common in boys than girls. KD is not contagious.

A virus is the likely suspect in KD, but the cause is unknown. Initial symptoms include the following:

  • Strawberry tongue and cracked, swollen, bright red lips
  • Swollen hands and feet
  • Swollen neck lymph nodes
  • Fever lasting five or more days
  • Red, bloodshot eyes
  • Rash

Seek medical attention immediately if your child displays any of those symptoms along with a persistent fever.

Scarlet Fever

Strawberry tongue symptoms can also point to scarlet fever. This bacterial illness sometimes develops in people who have contracted strep throat, explains the Mayo Clinic. Scarlet fever causes a bright red rash that resembles a sunburn, feels rough like sandpaper and envelops most of the body. In addition to the strawberry tongue and red rash, the face will be flushed with a pale ring around the mouth. Red lines will emerge in the skin folds around the elbows, knees, neck, armpits and groin. A fever of 101°F and chills can be accompanied by nausea, vomiting or a headache.

Scarlet fever occurs mostly in children ranging from 5 to 15 years of age. Thanks to antibiotics, scarlet fever isn’t as serious as it once was. Though, left untreated, it can spread to the kidneys or cause rheumatic fever, a condition that affects the heart. Bring your child to the doctor if their symptoms include a fever, sore throat, swollen glands and red rash.

Treatment Options for Strawberry Tongue and Related Conditions

The correct course of action depends on the condition. An antihistamine can treat minor allergic reactions, while an epinephrine injection might be necessary for severe reactions. Vitamin deficiencies can be corrected with diet improvements or a vitamin B-12 injection.

Seek medical assistance for Kawasaki disease or scarlet fever. Treatment for Kawasaki disease includes measures to reduce fever and inflammation. Injections of immune system proteins may be necessary. Scarlet fever treatment requires a full course of antibiotics.

Book an immediate consultation with your doctor if you think your child has a strawberry tongue, as it could be a sign of something serious. Regardless, your child should still see a dentist regularly to monitor their mouth health and for regular cleanings.