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Dr. Andrew Rynne

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Hi there, my daughter is 5 years old. She had

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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3703 Questions

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Posted on Tue, 29 Jan 2019 in Digestion and Bowels
Question: Hi there, my daughter is 5 years old.
She had ulcers on her tongue 2-3 weeks ago (was in pain, so couldn't eat/drink/talk) and we took her to the doctor who said she had oral thrush/fungal infection in her mouth, so was prescribed daktarin oral gel for 7 days, 2 times a day.
This cleared it up. It's been clear for a week now, but her lips are constantly dry even though we keep her hydrated.
Her tongue seems fine, but I think she is biting the insides of her cheeks now - is it possible the ulcers/fungal infection hasn't cleared up?
She has also developed a rash around her mouth, which started yesterday. Is it possible the fungal infection is now on her face around her mouth?
What can we do for her now before we can book in to see her doctor?
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Follow up: Dr. Diptanshu Das 0 minute later
Hi there, my daughter is 5 years old.
She had ulcers on her tongue 2-3 weeks ago (was in pain, so couldn't eat/drink/talk) and we took her to the doctor who said she had oral thrush/fungal infection in her mouth, so was prescribed daktarin oral gel for 7 days, 2 times a day.
This cleared it up. It's been clear for a week now, but her lips are constantly dry even though we keep her hydrated.
Her tongue seems fine, but I think she is biting the insides of her cheeks now - is it possible the ulcers/fungal infection hasn't cleared up?
She has also developed a rash around her mouth, which started yesterday. Is it possible the fungal infection is now on her face around her mouth?
What can we do for her now before we can book in to see her doctor?
doctor
Answered by Dr. Diptanshu Das 54 minutes later
Brief Answer:
Could be due to vitamin B12 deficiency

Detailed Answer:
Thanks for using the Ask a Doctor service.

The oral ulcers could be due to vitamin B12 deficiency. I would insist you to give her De-DATE Syr (Vitamin B12 And Zinc Haematinic Syrup) or any other Vitamin B12 supplement for a week or so. It is possible that a fungal infection is there but it might not be the main contributor. I think that the oral lesions will clear up. Feel free to use the daktarin oral gel again for the next few days.

Feel free to write back.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
doctor
Answered by Dr. Diptanshu Das 0 minute later
Brief Answer:
Could be due to vitamin B12 deficiency

Detailed Answer:
Thanks for using the Ask a Doctor service.

The oral ulcers could be due to vitamin B12 deficiency. I would insist you to give her De-DATE Syr (Vitamin B12 And Zinc Haematinic Syrup) or any other Vitamin B12 supplement for a week or so. It is possible that a fungal infection is there but it might not be the main contributor. I think that the oral lesions will clear up. Feel free to use the daktarin oral gel again for the next few days.

Feel free to write back.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Diptanshu Das 8 hours later
thank you doctor.
I will give this a go - interesting to read up about b12 deficiency. Our daughter is on the spectrum, so I wonder if this will improve. We will try anything and everything.
I've been giving my kids GNC multivitamins every day - thinking that it would contain all types of vitamins in it. But I don't think it contains b12.
Thank you again.
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Follow up: Dr. Diptanshu Das 0 minute later
thank you doctor.
I will give this a go - interesting to read up about b12 deficiency. Our daughter is on the spectrum, so I wonder if this will improve. We will try anything and everything.
I've been giving my kids GNC multivitamins every day - thinking that it would contain all types of vitamins in it. But I don't think it contains b12.
Thank you again.
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Follow up: Dr. Diptanshu Das 13 minutes later
actually I just checked the multivitamins and it says that it contains 3mcg of B12.
She isn't vegan, she eats octopus at least once a week and we have meaty meals nearly every day... she doesn't consume all of the meals, but we make sure she eats enough.
How much B12 can I give to her? Let me know thank you doctor.
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Follow up: Dr. Diptanshu Das 0 minute later
actually I just checked the multivitamins and it says that it contains 3mcg of B12.
She isn't vegan, she eats octopus at least once a week and we have meaty meals nearly every day... she doesn't consume all of the meals, but we make sure she eats enough.
How much B12 can I give to her? Let me know thank you doctor.
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Follow up: Dr. Diptanshu Das 1 minute later
and drinks milk in excess - morning, noon and night. :-)
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Follow up: Dr. Diptanshu Das 0 minute later
and drinks milk in excess - morning, noon and night. :-)
doctor
Answered by Dr. Diptanshu Das 3 hours later
Brief Answer:
Methylcobalamin (Vit b12) formulation is available

Detailed Answer:
Welcome back,

3mcg of Vit B12 will not suffice. 500 mcg or more will be needed per day. Formulations are available in form of drops and capsules.

Regards




Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Diptanshu Das 0 minute later
Brief Answer:
Methylcobalamin (Vit b12) formulation is available

Detailed Answer:
Welcome back,

3mcg of Vit B12 will not suffice. 500 mcg or more will be needed per day. Formulations are available in form of drops and capsules.

Regards




Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Diptanshu Das 48 minutes later
ok thank you doctor. Will give it a week and see how she goes. Thank you :)
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Follow up: Dr. Diptanshu Das 0 minute later
ok thank you doctor. Will give it a week and see how she goes. Thank you :)
doctor
Answered by Dr. Diptanshu Das 5 hours later
Brief Answer:
Glad to be of service

Detailed Answer:
Feel free to write back in case of further queries.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Diptanshu Das 0 minute later
Brief Answer:
Glad to be of service

Detailed Answer:
Feel free to write back in case of further queries.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Diptanshu Das 18 hours later
I'm having trouble trying to find the B-12 in liquid form - we live in Costa Rica, so a few things are harder to find. I do have it in a tablet, but she would not be able to take it. perhaps I can crush it and put in a drink? I'm going to attach a picture of her face, as the rash around her mouth has gotten worse. I sent a picture to her pediatrician, who has suggested Elidel cream on it. She has scratched it this morning, hence the blood.
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Follow up: Dr. Diptanshu Das 0 minute later
I'm having trouble trying to find the B-12 in liquid form - we live in Costa Rica, so a few things are harder to find. I do have it in a tablet, but she would not be able to take it. perhaps I can crush it and put in a drink? I'm going to attach a picture of her face, as the rash around her mouth has gotten worse. I sent a picture to her pediatrician, who has suggested Elidel cream on it. She has scratched it this morning, hence the blood.
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Follow up: Dr. Diptanshu Das 18 minutes later
Elidel twice and a day and then mupiral cream 3 times a day
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Follow up: Dr. Diptanshu Das 0 minute later
Elidel twice and a day and then mupiral cream 3 times a day
doctor
Answered by Dr. Diptanshu Das 21 hours later
Brief Answer:
Could be due to herpes virus

Detailed Answer:
Sorry for the inadvertent delay. The attached image does not indicate vitamin B12 deficiency. Rather, it is more likely to be due to herpes. I need to ask if the rash is painful.

Feel free to apply the prescribed creams.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Diptanshu Das 0 minute later
Brief Answer:
Could be due to herpes virus

Detailed Answer:
Sorry for the inadvertent delay. The attached image does not indicate vitamin B12 deficiency. Rather, it is more likely to be due to herpes. I need to ask if the rash is painful.

Feel free to apply the prescribed creams.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Diptanshu Das 54 minutes later
I don't think it's painful, I think she is just irritated that it's there. The mupiral has helped, it's dried it out. so it's starting to scab again.
Because she's on the spectrum, once her focus is on something, she will focus on it all day.. so yesterday, she was just making it bleed continuously by scratching it.
Once I had the idea of putting a tissue on it to apply pressure, it took her mind off it and she stopped scratching it, but has been applying a tissue to the area.
Today, I've put a bandaid over it and that has given her some relief I think, from scratching also.
How would she have gotten herpes? Is this normal??? :( It all started when she cut her lip there with a zipper a few days ago, then we went to a restaurant to eat. Could it have been that something touched her cut on her lip and it spread from there?
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Follow up: Dr. Diptanshu Das 0 minute later
I don't think it's painful, I think she is just irritated that it's there. The mupiral has helped, it's dried it out. so it's starting to scab again.
Because she's on the spectrum, once her focus is on something, she will focus on it all day.. so yesterday, she was just making it bleed continuously by scratching it.
Once I had the idea of putting a tissue on it to apply pressure, it took her mind off it and she stopped scratching it, but has been applying a tissue to the area.
Today, I've put a bandaid over it and that has given her some relief I think, from scratching also.
How would she have gotten herpes? Is this normal??? :( It all started when she cut her lip there with a zipper a few days ago, then we went to a restaurant to eat. Could it have been that something touched her cut on her lip and it spread from there?
doctor
Answered by Dr. Diptanshu Das 7 hours later
Brief Answer:
Should soon be fine

Detailed Answer:
Welcome back,

Getting herpes is normal. The cut with zipper is possibly unrelated. Just continue to apply the ointments and things will soon be fine.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Diptanshu Das 0 minute later
Brief Answer:
Should soon be fine

Detailed Answer:
Welcome back,

Getting herpes is normal. The cut with zipper is possibly unrelated. Just continue to apply the ointments and things will soon be fine.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Diptanshu Das 38 hours later
Thanks Doctor, it's getting better today, and will keep an eye on her healing. Thank you.
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Follow up: Dr. Diptanshu Das 0 minute later
Thanks Doctor, it's getting better today, and will keep an eye on her healing. Thank you.
doctor
Answered by Dr. Diptanshu Das 3 hours later
Brief Answer:
Glad to be of service

Detailed Answer:
Feel free to ask back in case of further questions.
Above answer was peer-reviewed by : Dr. Raju A.T
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doctor
Answered by Dr. Diptanshu Das 0 minute later
Brief Answer:
Glad to be of service

Detailed Answer:
Feel free to ask back in case of further questions.
Above answer was peer-reviewed by : Dr. Raju A.T
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