Strawberry tongue is characteristic of?

KPSC Staff Nurse - 2015

Child Health Nursing (Pediatrics)

Easy

Appeared in: KPSC Staff Nurse - 2015

Explanation

The image displays a strawberry tongue, characterized by a bright red surface and prominent papillae.
This sign is a classic and principal diagnostic criterion for Kawasaki disease, an acute vasculitis affecting medium-sized arteries, particularly the coronary arteries.
Kawasaki disease diagnosis is based on a persistent fever (≥5 days) plus four of five clinical criteria, one of which is changes in the oral mucosa, including a strawberry tongue.
Early recognition and treatment with intravenous immunoglobulin (IVIG) are crucial to prevent coronary artery aneurysms, the most serious complication.

Option A: Tetanus is a neurological disease caused by a bacterial toxin. Its hallmark symptoms are muscle stiffness and spasms (lockjaw), not mucocutaneous changes like a strawberry tongue.
Option B: Leptospirosis is a zoonotic bacterial infection. Its classic presentation includes fever, myalgia, headache, and conjunctival suffusion (redness without inflammation). It does not cause a strawberry tongue.
Option C: Tuberculosis is a chronic bacterial infection, primarily affecting the lungs. Its symptoms are typically chronic cough, weight loss, night sweats, and fever. Oral manifestations are rare and do not include a strawberry tongue.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Recognition of characteristic clinical signs of pediatric infectious and inflammatory diseases as background academic context rather than a clinical decision trigger.
Recognizing a strawberry tongue is a critical nursing assessment skill, as it is a key sign of Kawasaki disease, which requires urgent treatment to prevent long-term heart damage.
Nurses play a vital role in monitoring for the full constellation of Kawasaki symptoms, administering IVIG and aspirin, providing comfort measures (e.g., oral care for cracked lips), and educating parents about follow-up echocardiograms.
What if? If the child with a strawberry tongue also had a fine, sandpaper-like rash and a sore throat, the diagnosis of Scarlet Fever (caused by Group A Streptococcus) would be more likely. While both can have a strawberry tongue, the associated symptoms help differentiate them.

How to Approach the Question

First, analyze the image provided. Identify the key clinical finding: a bright red tongue with prominent papillae, which is known as a 'strawberry tongue'.
Next, read the question carefully: 'Strawberry tongue is characteristic of?'. This is a direct recall question linking a clinical sign to a disease.
Evaluate each option based on your medical knowledge. Consider the typical presentation of each disease.
Tetanus (lockjaw), Leptospirosis (fever, myalgia), and Tuberculosis (chronic cough) are not known for causing a strawberry tongue.
Recall or deduce that Kawasaki disease, an acute pediatric vasculitis, has strawberry tongue as one of its classic diagnostic criteria.
Confirm your answer by selecting the option that directly and characteristically presents with the sign shown in the image and asked about in the question.

Concept Tested & Keywords

Concept Tested: Recognition of characteristic clinical signs of pediatric infectious and inflammatory diseases.
Stem keywords: Strawberry tongue, characteristic
Lead-in keywords: BEST, MOST RELEVANT CLUE
Clinical cues: The image shows a classic strawberry tongue, a key diagnostic sign.

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