Ear, Nose, and Throat Disorders

Viral glossitis

03/22/2006

Question:

I am a 39 year old female and was under a lot of relationship stress for over a year. In late June of 2005 my tongue fissured, completely white coated, and bumps all over. Two days later I broke out in shingles on my neck. The shingles cleared in about a month. Several months later, tongue not clearing and getting worried I went to two docs and an Ear Nose Throat specialist who diagnosed me with Viral Glossitis. The ENT doc also said that the tongue issue more than likely was related to the shingles. And, should clear in another 3 months. It is now beginning of March, 2006, more than 3 months later, and almost 1 year later since this started, and my tongue has still not cleared up. I would really like to have my tongue back to normal. Please, any help would be appreciated. Thank You!
The reply:
A viral glossitis would be most unusual. The tongue can take on a fissured appearance, or develop unusual patchy changes in color (geographic tongue), all as part of a normal variation. If you are not having any associated symptoms, such as pain or taste distortion, then it probably does not require therapy.
If you are bothered by the appearance, then I would suggest brushing the tongue when you brush your teeth, and perhaps try a peroxide (mixed with water half and half) gargle. A more likely infectious source would be yeast, rather than viral. This can be treated with an anti fungal or anti yeast gargle, best prescribed by your physician.
If it is not viral glossitis then what could it be? I forgot to mention... when this first started there was a lot of pain from the fissures and taste distortion... that cleared up... I also have tried your above suggestions.. I was prescribed anti fungal meds and that didn`t help, brush my tongue regularly, and trie dthe hydro-peroxide/water mix.. any other suggestions of what it could be or thoughts?
Is this cureable? will it clear up?
thanks much for your previous help.

Answer:

I also doubt that it is a viral induced glossitis, especially after this much time. It is encouraging that the associated symptoms of pain and taste changes have resolved. I doubt that the relationship stress has anything pathophysiologic to do with your tongue, but it may make you more vigilant to such changes. The suggestions that were previously made are all valid. Other things that change the appearance of the tongue are smoking and possibly (but less likely) acid reflux into the throat and mouth. The appearance of the tongue has a wide spectrum of normal. It is likely that you had a fungal/yeast infection with the associated signs and symptoms that has resolved with some residual appearance changes. If the other symptoms do not recur, I doubt that it is something that needs treatment. If symptoms change, do not hesitate to see a physician.

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Response by:

Michael J Wolfe, MD
Assistant Professor
Department of Otolaryngology
College of Medicine
University of Cincinnati