Problems with the mouth and throat 305
Sores, cracks, and blisters around the mouth
Painful blisters and sores (also called cold sores or fever
blisters) on the lips can be caused by the herpes virus. A healthy
person can get these sores after a cold or fever. Someone with
HIV can get these sores at any time. The sores may last a long
time, but they usually go away on their own. To help prevent
infection, apply gentian violet to the sores. A medicine called
acyclovir may also help (see the “Green Pages”). Wash your
hands after touching the sores.
White patches in the mouth (oral thrush)
Thrush is a fungal infection that causes white
patches and soreness on the skin inside the
mouth, on the tongue, and sometimes down the
throat.This can cause pain in the chest.
The patches look like milk curds stuck to the
cheek or tongue. If the patches can be scraped off, it
is probably thrush. A person with HIV who gets oral thrush may
need to start taking ART (see page 517).
Gently scrub the tongue and gums with a soft toothbrush
or clean cloth 3 or 4 times a day. Then rinse the mouth with
salt water or lemon water and spit it out (do not swallow). In
addition, use any ONE of these remedies:
1. Suck a lemon if it is not too painful. The acid slows the
growth of the fungus. Or,
2. Rinse the mouth with 1% gentian violet liquid 2 times a day.
Do not swallow. Or,
3. Put 2.5 ml of nystatin solution in the mouth and hold it
there 2 minutes and then swallow it. Do this 5 times a day
for 14 days. Or,
4. If thrush is very bad, ketoconazole may help. Take one
200 mg tablet, once a day with food for 14 days (but do not
take this medicine if you are pregnant).
➤ Cracks and
sores in the corner
of the mouth can
also be caused by
Difficulty swallowing (esophageal thrush)
Thrush can move down into the tube that goes from the
mouth to the stomach (the esophagus), and swallowing becomes
so painful the person cannot eat or drink. If this happens, the
person needs urgent hospital care. If the person can still swallow
medicine, she should take fluconozole 400 mg at once, then
200 mg daily for 14 days. If the person is no better in 3 to 5 days,
double the dose to 400 mg daily.
➤ If you are
breastfeeding, do not
take fluconozole (see
the “Green Pages”).
Where Women Have No Doctor 2012