A person with a two day history of a burning tongue

Recently, I was having coffee with a friend. He asked me what could be causing his two day history of burning tongue.

His tongue and mouth appeared normal and he had never had any symptoms like this before.

He is 74 years old and in good health although he is being treated for type II diabetes, high blood pressure, and high cholesterol. He sees his doctor every six months and gets blood tests with his visits. His most recent doctor visit was two months ago.

He reports that he had a toothache two weeks ago for which he saw his dentist who prescribed an antibiotic for ten days (he did not know the name but it may have been Pen VK).

He reports that his burning tongue began just after he had finished his antibiotic. His tooth pain also resolved.

Burning of the tongue is a condition called glossitis.

Glossitis can be caused by a candida infection, a viral infection, medications, systemic diseases (for example celiac disease, amyloidosis, and others), nutritional deficiencies (iron, folate, vitamin B12, riboflavin, and niacin).

There are other causes of glossitis detailed in the reference below.

The most likely cause of my friend’s symptom of burning tongue is a candida infection following his antibiotic and the treatment for it is an antifungal like nystatin oral suspension.

His symptom should completely resolve with treatment in a few days.

If an antifungal did not relieve his symptoms then a re-exam by his dentist or doctor is indicated and some blood tests might be indicated.

My friend already had an appointment with his dentist for later that day and he just wanted to talk about with me.

Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care. Am Fam Physician. 2010;81(5):627-634.

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