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Painful small white spots on the tongue
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Painful small white spots on the tongue

Background:

I'm 45 and have Herpes Simplex II for about 10 years and due to laziness, have just now begun being treated for it with daily suppression therapy using Acyclovir. It works fine.

Ironically, I'm one of those with Simplex II who only suffers oral symptoms. (You may know that due to the prevelance of oral sex, the line between I and II has blurred.)

I have performed oral sex on women who were suffering from yeast infections, in the past. I am divorced, and have had multiple sex partners.

About 6-8 years ago I began suffering from a symptom: various taste buds on the top of my tongue turning white and becoming painful, each feeling like tiny pin pricks on my tongue. No bleeding.  I always thought that this was a symptom of herpes (even though I was suffering pain - and pain does not usually accompany herpes outbreaks). My tongue symptoms are worse when I was under stress, and after I ran the Chicago Marathon my tongue broke out with about a dozen such white "spots" that were very painful indeed.

I went to see an ENT specialist, but the spots went away before the appointment and there was nothing for him to see or diagnose, so he just sent me home without a diagnosis.

I'm writing this because the suppression therapy took away my herpes symptoms, but the tongue pain outbreaks are still going on. I am also under a lot of stress at work.

There is no pain were the white taste buds are not - only pain traceable to the whitened spots.

Also, the white taste bud like spots come and go in different areas of the tongue, like chicken pox - again, suggesting a herpes connection.

I've been tested for all STD's and HSVII was the only positive result.

A friend suggested Epstein-Barr.

I'm stumped. Got any ideas?

Thanks.
Tags: spots, Oral, years
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239123_tn?1267651214
I wish I could help, but the symptoms you describe do not sound like any STD I can think of; and no STD would cause continuing or intermittent symptoms like that for several years.  It certainly does not sound like herpes.

It may or may not be pertinent to your question, but I am skeptical that you have recurrent oral herpes due to HSV-2.  If you are going by symptoms plus a positive blood antibody test for HSV-2, that is insufficient; you would need a positive culture for the HSV-2 virus itself from a recurrent oral lesion to be confident that was the cause.  But in any case, you can be confident herpes isn't the cause of the white spots on your tongue.

Sorry I can't be of more help--   HHH, MD
5 Comments
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Some possibilities could be:

Herpes, Candidiasis, Geographical Tongue, Recurrent Aphthous Ulcers, to more sinister conditions.  The list could go on and you will be able to get a definite diagnosis here.  I know you have seen an ENT specialist but they disappeared before your appointment, but if they come back, try to get another appointment.  A examination in person is required to get a definite diagnosis.  Good Luck.

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Avatar_n_tn
Sorry Eric, that should read you will be "UNABLE" to get a definite diagnosis here.  Good Luck.
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Avatar_n_tn
The elevated white spots on your tongue are NOT herpes.  I can tell you this for sure and I'm not a doctor.  Have you looked very closedly at these "spots"?

If you look closely you may realize that they are simply an inflamed "bump" on your tongue.  You tongue is not smoothe but consists of hundreds of small raised buds.  Occasionally a single "bud" becomes inflamed.  It will become white, swollen and painful.  This is quite common and they can occur several times a year.  My stepfather calls them "lye bumps" which I'm sure is not the appropriate medical term but rest assured its not herpes
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After I requested this post I found an older woman had made the inquiry on a British version of this website.  The British doc there suggested gargling with an antiseptic mouthwash and forgetting about it (there was nothing to worry about).  

I tried it, and it worked!  Instantly the pain was gone.  Wow.  It stayed gone, too.

Thanks.
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Avatar_f_tn
This sounds like transient lingual papillitis, also known as "lie bumps". Its a short-lived swelling of the papillae. Typical treatment is topical analgesics and NSAIDS. Although the cause is unknown, it is not herpes, and not contagious.
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