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Ask the Experts about Oral Health and HIV

 

Worried - Need your help
Aug 18, 2000

Dear Dr,

I have some sort of white coating on side of my mouth, most of the time at the corner, rarely at below the tongue. My doctor did take look under microscope and said it's thrush. I took Micelex for 10 days, but that didn't help.

I am having this problem for past 16 months.

19 months back I had on very low risk exposure. After that I took 5 HIV antibody test by Elisa, latest one is after 17 month. Also took one HIV PCR RNA after 2 month, one bDNA ultra sensitive down to 50 copies after 16 month, one PCR DNA ultrasensitive down to 50 copies after 17 month. All are negative.

I am under severe stress for all this time. My doctor said, thrush because of Severe stress. I am trying to cool down myself, but I can't.

I do have some medical conditions, I am suffering with Sinus for past 2 year, it's very severe sometime.

I don't know what to do, This thrush is not going off. I am worried a lot, Please help me.

I will be very thankful to you for your help.

Thanks a lot.

Response from Dr. Reznik

Due to the fact that you have received this diagnosis after a medical professional examined you and looked under a microscope to verify the presence of candidiasis, there are a few reasons why your treatment with Mycelex troches was unsuccessful.

1. treatment should be for two weeks with 5 doses per day. One reason Mycelex troches did not work may be due to inadequate dosing.

2. another reason may be due to the extent of the infection. Topical therapies are only effective when they come directly into contact with the candidal plaques.

If topical therapies are not working, I would suggest a two week course a Diflucan (200 mg on day 1, then 1 tab per day for the rest of the two week period of time.

Take care,

DR



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