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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Medical
Satisfied Customers: 3136
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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I have Painful sores on my tongue with elevated temperature

Customer Question

I have Painful sores on my tongue with elevated temperature which have not responded to triamcinalon (sp?). Mary's Magic Mouthwash or
JA: How long have you had the pain? What seems to make the pain better or worse?
Customer: Silver nitrate. I have had the pain for a week and I had it on the other side of my tongue for a month last summer.
JA: Anything else in your medical history you think the doctor should know?
Customer: No Medical problems but a LOt of recent stress: shoulder replacement,cellulitis right after that, broken L3, kidney stone. All since April 12. Two days after I got out of the back brace the sores started, then the fever and feeling crummy.
Submitted: 1 month ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 1 month ago.

Hi,

Im sorry to hear about your symptoms. Do you have a picture of the sores on your tongue? Any other symptoms? sore throat?

Expert:  Dr. Muneeb Ali replied 1 month ago.

Well painful sores on the tongue can be due to a number of causes. Since it is not responding to a number of treatments it is possible that it is a resistant form of fungus which is causing the ulcer. This would be best treated with the help of nystatin oral drops which is more powerful than triamcinolone and more effective in treating painful sores on the tongue. Now apart from a fungus it is possible that the sores are due to another cause. Apthous ulcers can occur on the tongue which can be due to concurrent other illnesses like the cellulitis which you had recently as well as other conditions. In addition they can also occur with stress as well as nutritional deficiencies. Infact it is very likely that you could have deficiency of iron, zinc or vitamind B12 which can be corrected with the help of simple supplements. Even folate deficiency can cause ulcers of these sort.

Similarly viral infections can also cause these sort of ulcers to develop as well as rare diseases like bechets disease in which the blood vessels are inflammed. So basically there are various causes for painful sores to develop on your tongue however i feel the two most likely here are fungal infections and nutritional deficiencies. I would suggest that you switch over to oral nystatin drops and also start using supplements of vitamin B12 and zinc and other minerals and see if that helps. If needed you can use the following OTC products as well,

  • Benzocaine (Anbesol, Kank-A, Orabase, Zilactin-B)
  • Fluocinonide (Lidex, Vanos)
  • Hydrogen peroxide (Orajel Antiseptic Mouth Sore Rinse, Peroxyl)

If none of these work then you will need oral prescription steroids to solve the problem.

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