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Have white blisters on tongue, black scabs on lips. Treated for herpes simplex 1. Effective cure?

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My grandmother is currently suffering from white blisters on tongue and black scabs on her lips. She has lost her voice. She was treated for herpes simplex 1 for seven days without any results. She was also being treated with Mary's Miracle Mouthwash for Thrush, no change. She is currently on antibiotics, with no improvement. She has been this way for 3 weeks, it began 3 days after surgery to replace a heart valve.

(The attached picture is not of my grandmother, but of a photo we have found on Google images that looks just about perfectly to how her mouth looks.)

Where we found the picture, said it was a common ailment in Tlamacazapa, Mexico.
Posted Mon, 25 Feb 2013 in Skin Hair and Nails
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for your query.

1. The image shows apthous stomatitis probably with methylene blue applied. I doubt it represents what your grandmother has.

2. If the current medication is not working, get a throat swab and a biopsy of a black scab from her lip examined.

3. This is probably an immune reaction, a septicemia or an invasive fungal infection such as mucor or aspergillus. Is she diabetic?

4. Get a videolaryngoscopy done since she has lost her voice and share the video or close up images here.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have white blisters on tongue, black scabs on lips. Treated for herpes simplex 1. Effective cure? 25 minutes later
I will take a picture of her mouth and send it to you through here. The doctors were talking about getting a throat swab and a biopsy, but it won't be until Monday, they let us know this on Friday.

She is not diabetic, but her blood sugar has been running about 150-170.

We will share this information with the doctors where she is at. I will be in contact with you with the picture, hopefully within the next 10 hours.

Thank you so much for you help.
 
 
Answered by Dr. Sumit Bhatti 23 hours later
Hi,

Thank you for writing back.

1. A few close-up images will help.

2. Hope the swab and biopsy are done.

3. High sugar in the tissues encourages bacterial and fungal growth.

Awaiting your reply,

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have white blisters on tongue, black scabs on lips. Treated for herpes simplex 1. Effective cure? 2 hours later
I added the pictures as reports. There are three altogether.
 
 
Answered by Dr. Sumit Bhatti 16 hours later
Hi,

Thank you for writing back.

1. These images look like phemphigus (auto-immune blisters) or an infection such as Candida (Thrush). Only a throat swab and biopsy can identify the cause.

2. The black scabs on the tongue may be fungal (Mucor, Aspergillus) or blood clots. What is her bleeding and clotting parameters? She must be on anti-clotting drugs after her cardiac valve replacement.

3. For fungal infections Candid (clotrimazole) mouth paint will be better. Can she gargle? You may give her a medicated gargle such as Chlorhexidine.

4. These are signs of severe illness.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Regards.
Above answer was peer-reviewed by
 
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