When am I gonna flush out this Thrush?
February 16, 2009 4:09 PM   Subscribe

I was diagnosed with Oral Thrush and am being treated with Diflucan. How long before I'm back to 100% normal?

Quick info: I had a bad case of bronchitis and was treated with a Z-Pack, Prednisone, and an oral steroid inhaler. Unfortunately I was sick during the busiest week of the year for me, work-wise, and my body always hates steroids (I cannot sleep EVEN with sleeping pills, get angry/cry easily, feel horrible, and generally eat too much).

The tipping point must've been eating roughly an entire bag of jelly beans last Tuesday. By Thursday, my mouth looked... scary as hell.

The doctor prescribed me 10 days of Diflucan, and this is day 5. The back half of my tongue still is kinda gross, but more importantly, has stayed in some kind of bad tasting/bad feeling stasis since roughly Saturday.

The doctor gave me no dietary restrictions or special instructions; however, as per my Internet research goes, I have tried to severely limit carbs, sugar, vinegar (all my favorite things!), and dairy (severely limit = less than or approximately 1 teaspoon or 1 serving per day of each "forbidden" thing). I've eaten at LEAST one clove of fresh garlic a day, sometimes as many as 3, often raw. Yogurt, too. I am taking acidophilus and flax seed supplements, brushing 3-4 times per day, flossing, and drinking water with fresh lemon squeezed into it.

My last dosage will be Saturday. I'm hosting a dinner-type party this Friday and am praying that my symptoms will have abated by then... so basically:

1. If you've had this, how many days before you actually had NO symptoms left? The Diflucan hurts my stomach, but I'm eating ok and have not lost weight.

2. Is there anything else I could be doing to speed this up? I've greatly increased my sleep/relaxing time, but am still doing moderate exercise (walking 3-4 miles a few times a week).

3. If I eat sugar/bread the last day of my dosage, will I sabotage the whole thing and re-infect myself? I promised my group a fabulous, sugar- and bread-laden brunch this Saturday, and am celebrating Valentine's with the gentleman caller this Saturday. It would KILL ME to not ingest any sugar. Well, kill is a strong word, but I would be seriously unhappy about it.

4. How soon can I kiss my significant other? As soon as the symptoms abate, or what? The doctor said kissing's fine as long as he's not "halfway down my throat" but I am wary.

Other factors: myself and the bf are tested HIV negative as recently as this week; I do not have any autoimmune diseases; I don't have any trouble or pain swallowing or white spots on the back of my throat; the front half of my tongue is pink and doesn't hurt and I have no fever, just a sort of general malaise feeling. Thank you!
posted by Unicorn on the cob to Health & Fitness (22 answers total)
Response by poster: I should also add that I'm on birth control pills and that may have been a contributing factor, along with all the other icky drugs combined.
posted by Unicorn on the cob at 4:23 PM on February 16, 2009

Ugh, this is why I hate antibiotics. Live yogurt usually clears it up for me in a few days, if it's still lingering after 10 days I'd go back to the doctor.
posted by fshgrl at 4:25 PM on February 16, 2009

When my daughter had oral thrush, it took about 2 weeks to go away but she was immunocompromised. In addition to diflucan, they also gave her oral nystatin, which we rinsed her mouth with about 6 times a day. That seemed to help her most with the discomfort.
posted by bunnycup at 4:28 PM on February 16, 2009

I recently shadowed a physician who is a specialist in infectious diseases, and the immune compromised patients with the worst thrush also had cuts, abrasions or other lesions in their mouths. According to the studies by the Lipke lab and others, the cell adhesion proteins of c. albicans adhere very well to the denatured proteins of wounded tissues. You could try brushing your teeth less often (1-2 times/day) so that your gums have a chance to heal. Probiotics (or yogurt) may help.

A quick glance at the suggested dosage for Diflucan shows that anywhere from 100 - 400 mg/day is suggested for oral candidiasis, so if your infection isn't responding to your current dosage, you could ask your physician about increasing the dose.
posted by abirae at 5:30 PM on February 16, 2009

You may have done this already: Talk to your doctor about the oral steroid inhaler as a cause a thrust infection. My experience: I had no illness, no sore thoat, but was diagnosed with asthma. Doc put me on a nasal steroid inhaler. Within 3 days of starting , I had the worst sore throat of my life - thrush. Asked my doc if there was a connection: "oh yeah, well that can happen. I guess you should stop using it." Two weeks after stopping, it was gone with the help of some oral antifungal - don't remember which one. Doc said "see, I told you." Sure, Daffy. Just not soon enough.

I never use those steroid inhalers again. You may not have that option, it sounds like your doc was going after an asthma condition with the oral/inhaled steroid duo.

Good luck
posted by buzzv at 5:45 PM on February 16, 2009

other sources of probiotics are kefir and kombucha tea. both available in your local health food store.
posted by fancyoats at 6:27 PM on February 16, 2009

I have to second the oral nystatin. I got a horrific case of thrush after having IV antibiotics after surgery and was completely miserable. The "swish and swallow" nystatin showed an improvement in 24 hours and I was back to normal in 72 hours.
posted by hollygoheavy at 6:23 AM on February 17, 2009

Response by poster: Okay, I am eating NOTHING but probiotics at this point and it's day 6 and barely any improvement. I'm taking 100 mg of Diflucan a day, and I am at the point of tears because of the pain in my mouth and the nausea. Should I just go back to the doctor? I went to a Primacare, so I can't call the doctor... it will involve another 2-4 hour jaunt to the doc-in-the-box. I'm not on any steroids at all anymore, just the Diflucan.

What I'm asking is, should I finish the course I'm on before I show improvements? I've heard anything from "give it a whole week/10 days" to "you may have to take several courses/change dosage." I have googled for days and found NOTHING else helpful on the internet, as this is not related to breastfeeding.

I'm trying to figure out if I should go back now or just wait and see... I've been sick for almost a month straight and would just like my life to go back to normal. Going back will be difficult, as I am in the process of moving and can't take much more time off work. Bear in mind I've eaten live yogurt and taken probiotic supplements the entire time. Should I suck it up and go back NOW or wait a few more days? My regular doctor is an hour's drive away, so either way, it's a good 3-5 hours I'll be taking to get this checked again, which work may not allow... thanks for any responses from people who've dealt with this personally.
posted by Unicorn on the cob at 8:25 AM on February 17, 2009

If you are in pain to the point of tears you should see a doctor as soon as possible. Why suffer? Fill a bag with all the medication you've taken in the past month (bronchitus stuff and all) and drive the hour to see your regular doctor. 3-5 hours of inconvenience is much better than staying in pain. If you call your doctor, they may be able to accommodate you at a time that would work with your work schedule.

I thought I had the flu recently, and kept putting off seeing the doctor, and couldn't understand why I wasn't feeling better. When I finally saw the doctor, she saw that I had strept, and after a course of antibiotics I felt worlds better. If your medication isn't helping, your doctor needs to change or modify your treatment, and the sooner you see her, the sooner you'll be feeling better. Please let us know how it goes.
posted by abirae at 9:48 AM on February 17, 2009

Call the doc.
posted by radioamy at 10:39 AM on February 17, 2009

Drive an hour to see your regular doc. You have an established relationship with them and can follow up with questions (like those you posted here) by phone if necessary.

Good luck and I hope you feel better soon!
posted by Herkimer at 11:07 AM on February 17, 2009

Response by poster: Good call, waiting in the dr. Office now you guys! Thanks everyone.
posted by Unicorn on the cob at 11:44 AM on February 17, 2009

Response by poster: Okay, just left with the Mycitex troches/lozenges, thanks for all who suggested I get more meds! Feeling MUCH relieved after a full blood workup. Just one stubborn patch that must be in love with me, bless its yeasty little heart.
posted by Unicorn on the cob at 1:53 PM on February 17, 2009

You might try Gentian Violet. My sisters twins got horrible horrible oral thrush that would not go away when they were tiny. They tried...whatever you try with teeny babies for weeks. After my sister showed up at the doc in tears for the third or fourth time he went with the GV. Cleared them both up by the next day.
posted by bilabial at 8:25 PM on February 23, 2009

PS Turned their cute little mouths PURPLE. And she said the stuff stains everything.
posted by bilabial at 8:26 PM on February 23, 2009

Response by poster: Oh hey, guys. Not really resolved after all. I'm posting this for anyone who ends up searching for Thrush or Oral Candidiasis later: After finishing 70 mycelex troches, 1 entire bottle of Nystatin and 1 10-day course of Diflucan, I am nowhere near cured. In fact, I'm removing the "resolved" tag because today was my first day of Noxafil.

I had to take an HIV test (negative!) and am getting a screening for breast cancer tomorrow to rule out all possible other causes (already know I haven't recently had a transplant or radiation therapy, thank goodness), but my doctor says I'm the third case he's seen in 20 years like this... I've had Thrush since February 11. It's now March 2. Apparently I am infected with some really rare strain of Candida or possibly something worse, but it is NOT hairy leukoplasia, I had a dentist rule that out after the 2nd prescription did not work.

Another 14 days of meds, and by then, I will have been on 4 different prescriptions for 32 days. I will post back if the Noxafil works; it took 3 days for it to get here as there was no place in the DFW area that carried it... if you don't have insurance, this medication is majorly expensive. There's not much online about it, so I will do my part to educate about it here.

If anyone has a really persistent case of Thrush, I'm going to post back about the Noxafil and how it works so that others might seek it out as an alternative. For what it's worth, I haven't had sugar, alcohol, caffeine, spicy food, white bread, simple carbs, or kisses for approximately 3 weeks, ate 1.5 bottles of 100 each acidophilus supplements, several cloves of garlic per day, and threw away my toothbrush each week.

The last doctor said it could be a strain called C. Krusei which apparently is found predominantly in intravenous drug users (which I am not). Again, posting for others' benefits should a similar situation arise.

Knowledge is power, I will update if the Noxafil works! Stupid fungi, stop having a party in my mouth!
posted by Unicorn on the cob at 6:06 PM on March 2, 2009

Response by poster: Well, ok, not removing resolved tag apparently, but adding some more for those that search in the future for similar/same ailment.
posted by Unicorn on the cob at 6:09 PM on March 2, 2009

Response by poster: This is the 7th day of Noxafil, still have some symptoms but they are gradually abating... will update more as I can... still have some sores/white spots on the back of my mouth, but they are gradually getting better... not sure if all will be gone by day 14.
posted by Unicorn on the cob at 12:38 PM on March 9, 2009

Wow! Thank you for the updates! If you are interested, you can read journal articles about Diflucan resistant species of Candida at PubMed. There are several articled about C. Krusei - most are about immune compromised patients though.

Did your doctor do a culture to figure out exactly what's living back there? (I'm just curious. I don't actually know if that's the thing to do, but it seems like it might be useful in an unusual case like yours.) Good luck!
posted by abirae at 2:36 PM on March 11, 2009

Response by poster: I've had two AIDS tests, a CDC, a mono test, a strep test and I had a dentist scrape my tongue to see if it was early signs of tongue cancer (hairy leukoplakia, I believe is what he was checking for...) -- all negative. However today feels like swallowing razor blades and I'm on day 30 of continuous meds for this infection, so I have an appt. with a specialist and possible endoscopy scheduled for tomorrow. I suppose I'll get the "real tests" tomorrow, since everything else is basically ruled out, including diabetes mellitus. I even went and had a breast cancer scan and my lymph nodes in my armpits are enlarged, but they can't tell if that is what is CAUSING this or if it's being caused BY the infection... bummer. If I don't get well and I go back in 4 weeks and the lymph nodes are not normal, I have to get a needle biopsy. I have to say, I'm pretty scared. I've stumped 4 doctors now and spent almost a grand trying to figure this out. I'll report back after I see the infectious diseases and soft tissue specialist tomorrow, provided I am not in the hospital!

Oh, wait... well, as long as I'm conscious I can update from my Blackberry. :)
posted by Unicorn on the cob at 1:18 PM on March 12, 2009

Response by poster: Just got out of the hospital. Apparently, I no longer have Thrush, but the massive amounts of medication plus stress plus my acid reflux had given me a wicked case of esophagitis. I just had an endoscopy and they removed several polyps from my stomach and biopsied my esophagus, which is striated with red bands.

Note: If you have Thrush and they don't culture it, just diagnose it by visual assessment, you might end up taking a shit ton of meds that tear up your stomach and leave you with lesions in your throat and the very back of your tongue that look SIMILAR to Thrush, but are actually raw spots from too much stomach acid. I daresay the tons of supplements, garlic and everything else I was taking trying to kill the yeast might have aggravated my stomach into this, even though I was trying to alkalize myself. This just goes to show that all that Candida diet stuff isn't necessarily the right solution!

A friend is on her way over to give me the 8-hour medical supervision I need until I can sleep and get my car from the hospital tomorrow. I'm posting this in case anyone else ends up in a similar situation... I had stopped my cimetidine (Tagamet) because it interfered with the absorption of my antifungals, and unfortunately, nobody told me to get Nexium or Protonix instead to help my stomach not eat itself. If anyone else comes down with Thrush and it doesn't respond to the first round of meds and you also have acid reflux, IBS, or chronic indigestion, you may end up where I did. Get a throat culture, take an alternative medication if you are on Tagamet, and avoid stress! I get my biopsy results on Monday and will be in bed til then. Everything checked out normal so far, so I am not really worried any more, just irritated (pun intended). Thanks everybody! Future question Googlers, I hope this helps you...
posted by Unicorn on the cob at 5:50 PM on March 13, 2009

Hi Unicorn. Are you still doing OK?

I had a question. What type of specialist did you see? An Infectious disease specialist?

I developed almost like a fuzzy patch of red bumps on the inside of my cheek after a bad bout of a canker sore. I've had it for about a month and half now. I saw the doctor 4 weeks ago. He did a scraping and a culture and said it was candida. He tried to prescribe me Nystatin, but I had a reaction to it. I was switched over to Mycelex, but after completing one bottle (one left to go), nothing has changed!

I've been tested for HIV (negative), diabetes, and other immune problems, all have come back normal.

I've also stopped eating sugar and anything with sugar in it. Eating garlic, and yoghurt, and raw greens, with some meat. Stopped drinking coffee.

This crap still won;t go away and I'm starting to get petrified!

Please let me know what type of specialist you went and saw, and let me know if you're doing better now.


posted by markhgordon at 12:46 PM on December 22, 2009

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