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Thickly coated tongues: a footprint of viral infection?

Dec 18, 2003

Dr. Boyle, I noticed in a question that someone mentioned to you that, among other recent symptoms, their tongue had become white.

My question may sound a bit trite, but I would very much appreciate your perspective: I had always been told, when growing up, that a white/coated tongue usually was a sign of a viral infection. Separate from situations involving thrush, is this true... can a coated tongue provide a clue to the fact that someone has a viral infection? I am asking, because ever since I was infected with HIV a couple of years ago, I have had a white, thickly coated CD4 counts have never gone below 600 during this time, so it's unlikely to be thrush. My ID doc, who has treated me during this time, has looked at it, but says that coated tongues are never the footprint of a viral infection. Is this the case?...or can a coated tongue clue a doctor into the fact that someone has a viral infection? (I also wonder why, in my case, a coated tongue appeared for the first time upon HIV/viral infection and has been there every day since...).

Many thanks.

Response from Dr. Boyle

There are a number causes of a "coated" tongue, many are harmless but some may serve as signs of infection. Without seeing your particular tongue, it is tough to comment on the significance of its being coated, but if it has been that way for years, hasn't caused any other symptoms or problems, and your ID doctor has evaluated it and feels its harmless then it probably is. Of course, you could request that he/she do cultures or a laboratory evaluation to make sure that it is, and if it is bothering you, physically or mentally, perhaps you should do that.

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