Reoccurring thrush on lips for someone that has been on ARV for a few years

[Miltonia15]

Hi all,

I Hope everyone is doing well in these uncertain times.

I'm putting this post out there to see if anyone has experienced this and looking for potential treatment options and advice.

Background health: I was a late diagnosis and developed AIDS, CD4 count was 96 . I have been on ATRIPLA since diagnosis 2015 and haven't had any major health issues since then.

Currently undetectable VL and latest CD4 count was close to 400

Current dilemma: around February this year I noticed a dry itch patch at the corner of my mouth while shaving, I didn't think too much of it at the time and thought it may be some dermatitis then it cleared up on it's own.

What followed was that both my top and bottom lip started flaking and felt dry all the time. I though I had a case of dry lips and lathered on the lip balm which didn't help and the edges of my mouth became very itchy.

I decided it was time to see my family doctor about this as it was starting to affect me on a daily basis. Immediately when he saw me and I explained my symptoms he said I have thrush and he is 90% sure it is. He was unable to take any swabs as the labs are busy processing for COVID tests.

I was prescribed antibitoics: Cefalexin & Trisul
Antiviral just in case it's herpes: Valaciclovir
Anti fungal oral gel: Miconazole nitrate

I was also advised to get a blood test for any underlying condition that could be affected to chelitis ( condition relating to lips )

I took theses meds until they finished and applied the Miconazole on my lips for a week, and once the symptoms have cleared for another week. - although it did have a drying effect on my lips and looked bad all the time

This takes us to present time where there was a good week without any symptoms and I thought this nightmare was finally over and my lips were healed only to realise that the symptoms have come back - the itchiness and dry feeling.

I spoke to my doctor again about the thrush coming back he asked which antibiotics I thought was effective, I said I wouldn't know as I was taking several at that time

I asked my doctor if an anti fungal pill or tablet would be worth trying he agreed this would be a good idea

I'm due to pick up more medication today and see how I get on, this has been a very mentally distressing couple of months for me as it has affected my social life, my appetite and overall self confidence.

My doctor thinks it's linked to my HIV as he said thrush should go on for this long but the blood test came back normal.

Could it be that the thrush has become systemic due to my immune system?

I couldn't find much information on the web relating to thrush on LIPS only oral thrush

Has anyone experienced a long episode of thrush that got better and came back?

Hoping for better days ahead and trying to remain positive 

[Grasshopper]

Hi,
from personal experience (in the past) the use/prolonged use of antibiotics can cause/result in oral thrush (this is caused by an imbalance between yeast/fungi and bacteria)

https://www.medicines.org.uk/emc/product/3998/smpc
"Other side effects such as genital and anal pruritus, genital candidiasis, vaginitis and vaginal discharge, dizziness, fatigue, headache, agitation, confusion, hallucinations, arthralgia, arthritis and joint disorders have been reported."

I had good results when severe bouts of thrush, with Diflucan

[J.R.E.]

Hi there,

The medication I used back in 2003, was DIFLUCAN. It knocked the thrush right out of me. I also has esophageal thrush. I believe at the time it was a 14 day treatment. Ask your doctor about Diflucan: ( I have never had thrush again ).


I also believe at that time, I was also on Zithromax, and perhaps one other antibiotic. Do a search here on the forums for thrush, and you will find some other tips, to help get over this. If you smoke give it up, If you drink alcohol, give that up for a while as well. Stay away from sugary drinks or snacks. Thrush loves to feed on this.

I also stopped with alcohol mouthwashes and switched to Biotene. Much easier on the mouth, and effective.

Also make sure to check if there is another underlying condition.

https://www.drugs.com/diflucan.html


https://www.cdc.gov/fungal/diseases/candidiasis/thrush/index.html


Good luck ---Ray

[Grasshopper]

In my case it was the Bactrim (for PCP) causing the Candidiasis

https://www.webmd.com/drugs/2/drug-5530/bactrim-ds-oral/details

"Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms."

[J.R.E.]

In my case it was the Bactrim (for PCP) causing the Candidiasis

https://www.webmd.com/drugs/2/drug-5530/bactrim-ds-oral/details

"Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms."

That reminds me, That I was on Dapsone at the time, of Diflucan, and zithromax,..  I couldn't handle the Bactrim


Ray

[harleymc]

When the world of social distancing rules how has a lip I reckon affected your social life?

[Miltonia15]

When the world of social distancing rules how has a lip I reckon affected your social life?

In a way it has made me very anti social even the thought of joining a Zoom session with friends has been difficult for me

The thrush does affect my speech as my lips can be uncomfortable to talk or smile.

I know with what's going on around the world what I'm going through isn't considered much. I've just had it for so many months with no real progress to this date.

Still keeping up the positive vibes   

[Miltonia15]

Hi there,

The medication I used back in 2003, was DIFLUCAN. It knocked the thrush right out of me. I also has esophageal thrush. I believe at the time it was a 14 day treatment. Ask your doctor about Diflucan: ( I have never had thrush again ).


I also believe at that time, I was also on Zithromax, and perhaps one other antibiotic. Do a search here on the forums for thrush, and you will find some other tips, to help get over this. If you smoke give it up, If you drink alcohol, give that up for a while as well. Stay away from sugary drinks or snacks. Thrush loves to feed on this.

I also stopped with alcohol mouthwashes and switched to Biotene. Much easier on the mouth, and effective.

Also make sure to check if there is another underlying condition.

https://www.drugs.com/diflucan.html


https://www.cdc.gov/fungal/diseases/candidiasis/thrush/index.html


Good luck ---Ray

Hi J.R.E.,

Thanks for the response!

I just came back from the pharmacy and picked up this second lots of medication and creams.

My doctor has prescribed me Fluconazole 150mg which I believe is the same as Diflucan. I take one tablet once a weeks for three consecutive weeks.

He also prescribed same antibiotics and the same antiviral as before.

I'm instructed to keep applying the anti fungal ( Miconazole 2% ) oniment & gel both on my lips and inside my mouth.

Here's hoping to banish this thrush after all these meds....

[J.R.E.]

Hi J.R.E.,



My doctor has prescribed me Fluconazole 150mg which I believe is the same as Diflucan. I take one tablet once a weeks for three consecutive weeks.

I was just looking at my past prescription records.  I was on 100mg dose of DIFLUCAN back in November of 2003. ( same as fluconazole)

There were 30 pills in the bottle with 5 refills. This was the period of time, that I had 16 t-cells,  I was also on Valtrex at the time along with Prednisone. But I was in pretty rough shape at that time. This was also the time, when my lips looked like raw hamburger !

I have a habit of keeping all my prescription records from Walgreens ( At the time). I have them bundled by year and sorted by Month/day .     I have 11 bundles of years. 

It also brings back some pretty bad memories of just how sick I was, as I go through those early years of 2003 and 2004.


I know this reoccurring thrush certainly isn't pleasant to have, but be patient, it will go away. If you need to refill a presription, asl you doctor for a refill a couple day before your out of fluconazole.

Also have some yogurt daily to replenish the good bacteria, that the antibiotics takes away. Antibiotics can bring on thrush.


Let us know in a few weeks how your doing with this--------Ray

[J.R.E.]

Ps,..

I've had a few people tell me through the years , that it was a little obsessive of me to keep these printed out Walgreens prescriptions.    But they do come in handy at times.!!

Ray

[leatherman]

last year, 20 years after my last bout of AIDS (with very low tcells), I began to have an issue with thrush*. Oddly enough it started with the very strange issue of geographic tongue. As that began to clear up I started having thrush in my mouth. Not every day but enough days of the week to be a problem. So now I'm on a daily dose of 100mg of fluconazole and that seems to have kept it in check.

*i really really hate thrush. both partners who passed away had terrible cases of it and both times when I was hospitalized with AIDS, I had terrible cases of thrush. I always run, not walk, to my doctor whenever I see an inkling of thrush.

Good luck with getting this issue cleared up!!

[Miltonia15]

Thank you all for sharing your experiences, I hope the my GP has given enough dosage for the fluconazole I have read online that one tablet does stay in the system for 7 days.

Perhaps he is hesitant to prescribe anything more.

I'll keep everyone updated!