Expert: John Thai, M.D. - 10/29/2007

Question
QUESTION: after i was hospitalized for pancreatitis in may(was on i v antibiotic)i came down with burning denuded tongue, tried nystatin and diflucan than nystatin for 4 weeks finally went away only to return 3 weeks later, had hiv oral rapid test at 4 and half months past my last exposure it was negative, than had rapid fingerstick oraquick at 6 months and one week and it also was negative, should i doubt these tests because of the reoccuring thrush.

ANSWER: Hi Mikael,

After doses of strong antibiotics, there is a risk for candidiasis (aka oral thrush). This should be the cause of the problem and shouldn't be associated with immunodeficiency from HIV/AIDS.

The best solution is to take Mycelex troches 10mg 5x/day for 14 days.

Regards,

John Thai, MD

---------- FOLLOW-UP ----------

QUESTION: i have done that, and the thrush as come back, its not the white stuff, its the erythematous candidiasis on  the tongue. In the face of this how reliable are my tests that i have had. should i retest?

Answer
Hi Mikael,

This is call Chronic Atrophic Candidiasis. Your physician should perform an antibiotic sensitivity test to determine if there is a resistance to anti-fungals. He/She should also tests if there are other causes. You may need to be hospitalized and placed on IV Amphotericin B. However, there is a high recurrence rate. Therefore, you may need to be on prophylactic Mycelex for awhile.

A referral to an otolaryngologist would be beneficial for future management.

Regards,

John Thai, MD