Oral thrush?

Joined
May 13, 2023
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Over the last few months, I’ve been struggling with what appears to be oral thrush.

Back in November, I was clinically diagnosed with oral thrush by an NP at a walk-in clinic. I was prescribed Nystatin, which I used for a few days till I saw my GP.

He referred me to an oral pathologist who, along with his associate, determined that it wasn’t oral thrush. They said that the excess dryness, which contributed to a white coating could be caused by lithium.

Confident that I didn’t have oral thrush, I decided to brush/scrape the coating thoroughly. That’s when my tongue began to bleed. Concerned, I saw an ENT who swabbed my tongue and had it tested for Candida. To my surprise it came back negative.

Given those results, I wanted to ask the following:

1. How accurate is an oral swab at detecting candida?
2. I read that oral thrush flourishes in a severely dry mouth. Could my medication contribute to a fungal infection?
3. Should I use my Nystatin prescription for 2 weeks to see if it makes a difference?

Just to add - I’m HIV negative, no known immune issues, no known diabetes, no recent antibiotics, no inhalers, no dentures.

TL;DR: Clinically diagnosed positive for oral thrush, prescribed nystatin, clinically diagnose negative for oral thrush, tongue bleeds when cleaned, negative oral swab.

Image 1 - typical build up
Image 2 - post brushing 1
Image 3 - post brushing 2
Image 4 - healed tongue (after bleeding)
 

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