Dear Dr, I live in the UK and safer sex education here has always tended to suggest that the main thing one should do to avoid HIV infection is to avoid unprotected vaginal or anal sex. I have followed this advice, but now and then participated in oral sex although I have never knowingly taken any ejaculate in my mouth. With this in mind I have always believed that I have been safe from HIV infection.

However, about 2 months ago I had a cold which went away in the normal manner but at the time and since then I have been going through high levels of stress. Following the cold I noticed that my tongue was coated in a pale greenish gungy substance. I brushed my tongue for about 1 1/2 months but it did not move the stuff away. The stuff has now turned whitish and is concentrated at the back of my tongue, although the rest of my tongue is seems coated to a lesser extent with the whitish creamy stuff. When I brush my tongue it clears it a bit but not totally and I can't brush the far back of my tongue as it makes me want to throw up!

I went to the Doctors and she looked a bit confused and said eventually that it looked like Thrush. I know this can be a symptom of HIV and has now thrown me into panic, making me even more stressed. About a year ago I did have what my Doctor said was a common skin infection on my face which cleared up after a course of anti-biotics. Could these 2 things be early signs of HIV? Or does the length of time between the 2 not suggest this? I have no other symptoms such as swollen glands etc.

Also, When my Doctor told me that she thought it was Thrush I was given some pastles to take. A funny thing was, my flat mate had a cold at the same time as me, and he had a pale greenish tongue following this and he now has the same whitish creamy stuff on it but hasn't been to the doctors. Could it have been caused by the cold virus that we both had, and is it possible that it isn't actually thrush but coated tongue as there are no red patches associated, although there do seem to be some raised lump things at the back of my tongue.

Please help as I am going out of my mind with worry.

Kind Regards, Rob

It is not uncommon for a primary care provider to confuse coated tongue with pseudomembranous candidiasis (thrush), which is the main reason I included a small section on coated tongue in the article which appears in this forum. Coated tongue, as I continue to mention regularly, is not related in any fashion to HIV infection. The "raised lump things" on the back of your tongue are part of the normal anatomy of the tongue and are known as circumvallate papillae.

I do not suggest that every time someone has a rash or presents with something "strange" in their mouths to run out and have a HIV test, but if it has been some time since you have had said test and you do feel at risk, then it is time.

Take care and I hope this helps!

DR