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Need your help Dr Young
Mar 24, 2013

My son called me yesterday to tell me that he thinks he has oral trush after going to internet probably, he called the office of his ID doctor but was after 5P.M so left a message for them to call him back as yesterday was Friday and the office will be closed until Monday,he finally talked with the doctor that was "on call" not his doctor but she too is an ID specialist, and she prescribed him Fluconazole tablets to take for 10 days, he is planning anyway to go to see his doctor on Monday, my questions are : 1) is ok to take this medication without the doctor seeing the patient?because the office is closed for the weekend,I suppose she is aware that my son is on Atripla, because this information should be in their computer. 2)my son's latest lab results as 2/14/13 were cd4 of 527 and 37% and undetectable, could a person get oral thrush with this numbers or could it be that his counts went much down in around 50 days? I know that today is Saturday maybe you do not answer during weekends, but I am praying that you do,I allways get so worry when any new thing happens to my son's health,this have been very hard on me,I try not to show him all my concerns,because don't want to depress him. Again as allways thank you so much for all the help. Worried Mom

Response from Dr. Young

Hi WM, good to hear back from you.

Worry not.

It's perfectly ok for your son to take fluconazole to treat possible thrush. I say possible, because not all white lesions/coating of the tongue is actually thrush-it's commonly over diagnosed (often confused for geographic tongue or just normal shedding of the tongue's epithelial lining).

Additionally, his labs suggest that he's doing fabulously- his viral load is undetectable and CD4 numbers in the normal range. While thrush can occur in people with normal CD4s it's more common among people whose counts are below 350.

Either way, no need to worry or have concerns.

I hope that helps. Abrazos for both of you. BY



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