What it means
The small bumps on the tongue (papillae) swell and stand out. Early on, the tongue may have a white coating with red bumps poking through (white strawberry tongue), which later peels to a bright red, bumpy surface. It is classically seen in scarlet fever and Kawasaki disease, and sometimes in toxic shock syndrome.
For the nurse
Look in the mouth of any child with fever and rash. Report it with the other findings, such as a sandpaper-like rash, red eyes, cracked lips or swollen hands and feet.
Related terms
scarlet fever
An infection with group A strep bacteria in which a toxin made by the bacteria causes a red rash over the body.
Koplik spots
Tiny white or bluish-white spots on a red base on the inside of the cheeks.
Kawasaki disease
An illness of young children in which the walls of medium-sized blood vessels throughout the body become inflamed.