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Diag. 9-12-99 HIV+ plus positive for Mono
Sep 24, 1999

CD4 count 191. Bleeding and pounding of the gums.Waking up with blood on pillow and blood clots in mouth. Is this normal so early on. What medication do you recommend,

Response from Dr. Reznik

This sounds very much like you may have a case of Necrotizing Ulcerative Periodontitis. Classic symptoms of this manifestation include "waking up with blood on your pillow and within your mouth as well as a deep jaw pain. This is normally a very painful manifestation that if left untreated can have serious consequences. Please visit your local dentist as soon as possible to have your mouth checked!

Treatment would include use of antibiotics such as Flagyl 250 mg four times a day for at least 10 days or Augmentum 875 mg used twice daily for at least 10 days. We always place our patients on a chlorhexidine containing mouthwash such as PerioGard (this is the best tasting of the chlorhexidine mouthwashes). The directions for use of PerioGard would be to rinse for one minute then expectorate (spit) twice a day for at least two weeks. DO not drink or eat for at least 20 minutes after rinsing to give the medication a chance to work. You would need to have a deep cleaning performed as soon as possible.

Take care!

DR


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