48/m rapidly growing with severe burning tongue since last 20 days....Medication given by Ent and dentist already alternatively Tab.MVBC Tab.Moxiclav 625mg Tab metronidazole 400mg Tab.Oflox 200mg Inj.eldervit since last 15 days Benzocaine for TA Steroid as prednisone and Deflazacrt 6mg kenacort for TA Tab .Limcee Ix CBC ALL FINDING WITHIN NORMAL RANGE WHAT COULD BE IT? NW PT DOESNT WANT ANY EXPERIENCE ON IT BCOZ HE SUFFERED LOT AND TILL NO RESULT PLZ WELCOME UR SUGGESTIONS be fast plz

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it's look like hyperplastic candiadisis which is not easy to remove like pseudo membranous candiadisis, most common in denture wearing patient along with typical future of angular cheilitis. advice to maintain oral hygiene and avoid hot and spicy foods. Continue the medication already prescribed.

and f t so. f.d . dm
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oral candidiasis with cheilosis ketakinazole BD for 2 week Tab Rebazen tid for 14 day Tab Folic acid OD for two months. Cream Laxanox application Betadine gargle with water 3 to 4 times / days. inj Vitcofol 1 ml IM for 2 week. biopsy

Candidiasis

Is there involvement of buccal mucosa?? Correct the nutritional status of the patient along with antifungal therapy. There is glossitis and angular cheilitis also observed. Consider oral pemphigus as another dd

no involvement of buccal mucosa
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its candidiasis fluconazole 400 od for 5 days or terbinafin250 od for 4 weeks b complex od folic acid 5mg bd orasep ot mouth paint thrice daily plenty of liquids avoid spicy diet stool softeners

maintain oral hygiene
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Its response medication bt within a week it again happens so I want to find out etiology frnds ...and all of u sugvest that is already given and continue. sorry for candid gum paint and Tab grisofulvin already continue no response to fluconazole and looks dry mouth bt inrraorally u can see normal salivation...confused!!

immuno compromised state???
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Consider taking a biopsy and send half for histopathology and other half for fungal culture and sensitivity. It is essential to rule out underlying malignant disease on which the fungus may be growing. After initial clinical response to the medicines the fungus must be growing back as the fungal hyphae remain above inside the malignant ulcer base.

If you have ruled out every thing, do rule out HPV causing Papilloma and Verrucus vulgaris too using Histopathology. They turn into stubborn oral warts overlapped by candida and don't respond to any medicines until surgically removed. Try tongue scrap specimen or biopsy to confirm it. Also, Too much antibiotics can suppress her oral mucosal good bacteria so kindly give her some break from them. Give her multivitamins and symptomatic local applicants only for some time. Sometimes too much ABs act like immunocompromised states itself..

Histo may reveal Dysplasia, keratosis and CA if any too..
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rule out diabetes..... this is'oral thrush' cap fluconazole 150mg for one week. candid mouth paint LA bd/TDs multivitamin supplements Tab.rifaximin 200mg bd for 5 days along with pre and probiotics bd. check for constipation also.... do not give any steroids.... maintain good orodental hygiene....

fluconazole 150mg od for one week.
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trench mouth with thrush....give nimarazole n oflaxacin combo 500 mg.each twice with kenacort gel n candid oral gel plus zocon 100 mg.dt once daily for 7 days and tab.septilin 2 tab.bd.for 30 days plus glycerine n g32 tab.powedered to b applied all over tounge n buccal mucosa.This should be supported by nimu para combo thrice a day and tab.oraflora to correct the intestinal n oral flora along with tab.limce to be chewed twice a day.

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