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thrush or hairy leukoplakia
Sep 18, 2001

I keep getting white stuff in my mouth, and my doc quickly dismisses it as hairy leukoplakia (I had it before, and I have CD4 ofless than 20). When I insist that using Sporanox gets rid of most of it, he says it's both HL and thrush. It's getting more agressive, and I'm worried I might be getting resistant to the Sporanox. He says don't worry, there's amphotericin. I've done that, don't EVER want to see that drug again. Is there anything else I can do? For either the thrush or the HL? Thanks for taking the time to answer. I've been dealing with this for a long time, and feel like I'm at the end of my rope.

Response from Dr. Feinberg

If your problem resolves, albeit slowly, with irtaconazole (Sporanox), then most if not all of what you have is thrush. Your doctor can order an antifungal resistance test on an isolate that's grown from a swab of your mouth when the infection is active. There are alternatives to IV amphotericin: oral amphotericin (our pharmacist makes up ampho B in flavored jello, so it's easy to keep in the refrigerator and easy to swallow, and swabbing the thrush once a day for 3-5 days in a row with a dye called 1% gentian violet, which can be ordered by a pharmacy.

If you do also have OHL, then you should treat it with an antiherpes drug such as acyclovir, valaciclovir or famciclovir. Good luck!

follow-up on dry eyes/dry mouth
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