Brief Answer:
Interesting photo and symptoms

Detailed Answer:
Good morning. I am a neurologist and can tell you that your symptoms sound very typical for a herpes zoster type of infection. When I first saw the "blister" you refer to I thought that it actually looked very similar to other smaller entities that were yet behind and to the left of the main one you are pointing to....making me believe they may have been simply papillae of the tongue (i.e. taste buds).

However, the more I look at them under high power the more I am inclined to believe that the other blisters are like that one which would make perfect sense if they were all herpetic lesions.

I'm not sure about the white coating on the tongue as well. You didn't mention anything about it but it covers a large portion of the tongue. Is that normal for you or do you have some type of thrush infection and could that be what's causing this problem and NOT the "blister." Have you tried brushing that white coating off? Are you a smoker? Do you have diabetes. Did you recently kiss anybody who might've had a herpetic infection on the lips or inside the mouth (even without knowing it?).

An ENT person should be able to look at what you're pointing to as the blister as well as the other ones that I can see on high power magnification to tell you whether or not these are simply enlarged taste buds on the back of the tongue...or herpetic lesions as well as find out about the white coating.

I can also see where the upper portion of the pharyngitis and soft palate are reddened. Have you had a strep test done? I would highly recommend that as well as a Monospot and HSV types 1 and 2 titers in blood. Your doctor may also go ahead and order other bloodwork at the same time that could along with your symptoms of facial burning by looking at vitamin B12, folate, vitamin D, D2, D3, FREE T4, TSH, ESR, and CRP, as well as a CBC with differential.

If appropriate for short term relief you can speak to your doctor about trying either GABAPENTIN or LYRICA for pain relief since this often gives good results for these types of symptoms until it's determined whether or not your problem is infectious or not.

I hope this addresses your concerns. If so, may I ask for the favor of a HIGH STAR RATING on our interaction and some brief written feedback.

Write to me in the future at: bit.ly/drdariushsaghafi for additional comments, concerns, or to upload more information that you would like me to look at as well.

If there are no further concerns or questions please do me the favor of CLOSING THE QUERY on your end so that the transaction can be archived and utilized by colleagues for other patients with similar symptoms. Do let me know in the future what the final outcome of any workup would be as well and I'll be happy to comment again on any questions or concerns.

This query required 19 minutes to read, research, and compile an envoy to the patient.

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Brief Answer:
Don't brush too hard then- the white plaque is probably oral thrush

Detailed Answer:
If that's the case then, don't brush too hard over your tongue since that white plaque will not come off.

It is very possible that your tongue coating is thrush (fungal infection) which can easily explain the sore throat. Whether or not the enlarged bumps are herpetic lesions or simply your taste buds would need more careful and personal up close examination by someone who can get a good light source in there and look at everything up close.

My guess is that you will need some type of oral rinse as well as a throat swab to rule out other concomitant infections. If it turns out that the bumps are herpes lesions then, you will also likely receive an antiviral such as acyclovir, valciclovir, or ganciclovir.

I hope this addresses your concerns. If so, I'd appreciate a HIGH STAR RATING on our interaction and a bit of written feedback.

Don't forget that you can always contact me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to upload more information such as labs or culture reports if you get them in the near future.

If there are no further concerns or questions please do me the favor of CLOSING THE QUERY on your end so that the transaction can be archived and utilized by colleagues for other patients with similar symptoms.

I'd love to know what you end up finding out on things if you'd care to share.

This query required 10 minutes to read, research, and compile an envoy to the patient.



P.S.

I would recommend you avoid any oral to oral or oral to body contacts etc. for the time being until you know more about what this is and how to treat it....there very well may be a contagious or transmissible entity here and you don't want anyone else getting the problem.

Cheers.

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