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Is it possible to have white tongue after potential HIV exposure? Taken Nystatin

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HIV AIDS Specialist
Practicing since : 1974
Answered : 1211 Questions
Is it possible to have a very white tongue 4 days after possible hiv exposure? many thanks I went to doctor one week after exposure (3 days after i noticed white tongue) and he put me on nystatin. after 3 days on nystatin, i still have a white tongue although reduced. He said it was not thrust, but geographic, but after much research, i dont think its geographic as stains do not move. I have a even white tongue. I have been scraping and cleaning for last 4 days. please advice.

i have spoken to many and some say 4 days is too early for hiv symptoms. I spoke to someone else and said sysmtons can show anytime. But I also read its typically at 2 to 4 week XXXXXXX Also, for thrust the immune system has to be highly compromised, but is it possible that its so low at day 4? I just did my RNA hiv test and waiting for results.

the night before i woke up with a very white tongue, i forgot to brush my mouth and 2 weeks prior i was using colgate teeth whitener. Could this be result of white tongue? if so, how long before it clears under medication iam taking nystatin?

Also, I am losing sleep, not eating enough, nervous, emotinal wreck, can this anxiety / stress cause this white tongue to maintain, perhaps from stomach acid from going many hours without eating, etc? I am otherwise fairly healthy and no fever, etc. I dont have any eye visable laisons on my tongue, but the hairs look very white when scraped. Also, no bleeding that i can see and no pain or discomfort. When i scrape my tongue, its more of a thicker saliva, but no "cottage cheese" as i have read.
Posted Thu, 13 Sep 2012 in HIV and AIDS
Answered by Dr. S. Murugan 1 hour later

Thanks for the query.

In HIV disease the real and obvious manifestations will occur only after 5-7 years or more, that is one's immunity has gone beyond the lower limit.

Of course, 30% of the individuals with HIV infection do manifest some symptoms related to’Flu’. That also will correspond to the sero-conversion (that will be around 2-4 weeks or later).

So before two weeks no manifestation can be expected in HIV disease. More over white tongue in HIV can be of two reasons.
1. Oral Thrush where white deposit over the tongue is seen with reddish signs of inflammation. The deposit is curdy or as you explained cottage cheese appearance. As you ruled out this, possibility of oral thrush is out of question.
2. Oral hairy leukoplakia: It is also a bit late manifestation where the deposit is mainly over the lateral border of the tongue like vertical serrations or lines with shiny white nature.

Your symptom of white tongue is highly unlikely to be due to HIV exposure 4 days ago.
Is there any suspicion of HIV through earlier risky sexual contact? - If so, the results of the HIV RNA PCR test will strongly rule that out.

If it isn't geographical tongue may be your problem is due to long gap in your food habit or may be due to your forgetfulness of night brushing.

So don't worry. Continue with the current treatment as suggested by your doctor.

Hope this answers your query. Let me know if you have further enquiries.

Have a great day.

Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Is it possible to have white tongue after potential HIV exposure? Taken Nystatin 6 hours later
If the cause of my white tongue is not recent HIV infection, then what can cause it last over over one week withs medication Nytasti? Or is it perhaps something that the medication is not curing? Is it possible to be stress or anxiety or acid in stomach from lack of frequent eating? Iam not diabetic and not using inhalers and no recent antibiotic. My diet has not changed either, but I have had no alcohol in last 10 days.

Is white tongue not a symptom of seroconversion ?
Answered by Dr. S. Murugan 19 minutes later

Thanks for your feedback query.

Oral thrush is not a common symptom of seroconversion. You can be rest assured of that.

If Nystatin is not relieving the symptom it is unlikely to be oral thrush then. So more reasons to be assured it isn't related to HIV.

The white tongue can occur due to all of the causes (long gap in eating or acidity or geographical and even stress). I am unable to narrow down close possibility. Further as geographical tongue takes a very long time to clear, I suggest you to consult a dermatologist and dental surgeon to determine the cause and treat it appropriately

Hope I answered your query. Let me know if you have further concerns.

Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Is it possible to have white tongue after potential HIV exposure? Taken Nystatin 40 minutes later
Also, the person whom I had the exposure secures me that he is clean. He says he has been tested. But i still feel worried he's not telling me the truth , although he seems like an honest person.

On a more specific note, is it possible for the cd4 count cells to drop sharply 5 days after infection to cause a white tongue? Everywhere I read that white tongue is sign of infection. Also, someone at test center told me that white tongue can occur anytime even 3 days after infection, although not necessarily mean you have HIV. Is he wrong in saying even 3 days later? I hear the virus is not that quick but I also hear everyone is different.

Thank you for your responses. I will recommend your site to others. The best money I have spent to get clear answers. I assume you are a doctor well versed in HIV right? Thank you so much. Iam sure I will have more questions later.

Also wanted to point out I have taken antibody HIV test last week so that ruled out any past exposure. My only concern now is the exposure from 11 days ago. Also wanted to note my tongue is not 100 percent layered white, just about 80 percent and non white areas look fine. I have taken nastatin for about 4 days now . Thanks

Can you please tell me how long before nystatin cures my white tongue marks?
Answered by Dr. S. Murugan 13 hours later


I am pleased to answer your questions.

HIV enters into the body through skin or mucous membrane and from there it reaches the local lymph node, enters into the circulation and settles inside a CD4 cell. That would take around 72 hours from the entry of organism. This period is known as window of opportunity. CD4 counts gradually reduce from here and hence CD4 FALL TO THAT EXTENT to cause oral manifestation cannot be possible within 5 days.

Don't get confused with the news you read / told by others. I have plenty of experience with HIV patients and in this field for more than 25 years. It is highly unlikely that you could have HIV.

Nystatin will cure only oral thrush, not other causes of white tongue and oral thrush; also may be due to other reasons to occur other than HIV.

So if nystatin does not relieve the symptoms in 4-6 weeks time, consult your doctor for further evaluation.

Hope this helps. I will be pleased to answer any other queries that you may have.
If all your queries are answered, please close this discussion.

Above answer was peer-reviewed by
Follow-up: Is it possible to have white tongue after potential HIV exposure? Taken Nystatin 10 hours later
Thank for your answer.

My antibody result came back negative and Iam waiting on my RNA which should clear exposure from 11 days ago.
I went to an ear, throat and nose specialist yesterday and he prescribed Chlorhexidine oral rinse mouthwash. I have been on nystatine for 4 days but I still have a white tongue. Is it too early to expect results?

Also is the ear and throat anyway connected? I had an ear infection months ago and doctor gave me antibiotic. It took the pain away but I would feel like water occasionally and I kept putting swimmers drops to dry it out. Yesterday they cleaned my ear out and found I had yeast perhaps because the antibiotics and my persisting q tip cleaning had over cleaned the good bacteria causing yeast. My question is it possible for the yeast in ear to have spread through throat? The doctor said no but Iam not sure he understood my question.

Also, he he checked the back of tongue and down my nose and all clear. He said it does not look like thrush but maybe I have a little yeast and to continue the nystatin but gave me an Chlorhexidine oral rinse. Is it possible to have a little yeast but not thrush? Or is any yeast considered thrush?
Also, with this oral rinse, how soon before I see any result if indeed its a bacterial?
I know you said HIV infection cannot cause thrush at 5 days (although it's now 12 days after exposure, one week after white tongue appearing), but can HIV infection cause a white tongue at all?

I get my RNA hopefully Monday Tuesday the latest. Sorry for so many questions but Iam just a nervous wreck although the person with whom I had exposure said Hea tested and clean.
My only other exposure during the last 3 months was kissing a woman XXXXXXX French kissing.... But I heard that's not really risky exposure.
Thanks for answering the compound questions.

Also, I showed the initial pic of my tongue when I noticed it and was very white and he said it looked like geographic tongue. I have read lots about difference, but can u tell me how to differentiate? It's kind of harder now that I have been scraping and cleaning tongue constantly for several days now...

At what timeframe can there be oral manifestations of an infection? Also, I have heard its very unlikely to get HIV from receiving oral sex? I dont remember any cuts on my penis nor did I ejaculate... Thanks.

Sorry to clarify , the oral sex was several weeks prior to the white tongue....
Answered by Dr. S. Murugan 5 hours later
Ear and throat are well connected. Prolonged antibiotics may be a cause for yeast infection. It may take some more time to clear your problem totally. Chances of getting HIV through oral sex is very very remote possibility. Likewise kissing also is not a common mode of HIV transmission unless XXXXXXX kiss with contaminated blood.
Difference between the geographical tongue and other problems will better be explained by your examined ENT surgeon.
All I assure is that you do not need to panic with the above sequence of events.
Good day to you. If I have appeased you we can close the discussion now.
Above answer was peer-reviewed by
Follow-up: Is it possible to have white tongue after potential HIV exposure? Taken Nystatin 18 hours later
If I may ask doctor?
In summary if my oldest exposure is 6 weeks ( XXXXXXX kissing) and most recent is semen in my mouth 13 days ago (5 days after that exposure I had white mouth which I still have today 7 days later but lighter after been on nystatin for 5 days), is it still that these symptoms ( white mouth) cannot be a result of such resent HIV infection since I just took the antibody (cleared except for last 12 weeks) test and came back negative.

If I undertook you correctly, you said white tongue is not possie oral manifestation after 5 days and it's not common during the seroconversion timeframe which is 2 to 4 weeks because it takes longer for cd4 cells to cause it. Therefore is it fair to assume that any HIV infection during the last 6 weeks cannot manifest this oral tongue?
Please respond as specific as possible according to this specific facts. I know the risk exposures, but more concerned with the oral manifestations of white tongue.
As to date, I do not have any other symptoms other than some diahreaj because of constant stress and anxiety and eating only one meal a day. I dont feel week.

Also, how white is a normal tongue. I looked at my friends tongue yesterday and looked white too (he is African American so not sure if that makes a difference). I looked at a females and looked pinkier. Is a thin white coating normal?
Thank you.
Answered by Dr. S. Murugan 15 hours later

Welcome back.

I have noted to details of exposure and I still assure your problem of white tongue may not be an early symptom in HIV disease.

Now as it is partly getting cleared by Nystatin as per your words. You MAY HAVE TO have to wait for another three weeks for complete clearance.

Tongue is not naturally white. The white coating occurs due to multiple reasons, some of which I mentioned to you earlier. Instead of comparing your tongue with your friends, I would suggest you to go for HIV DNA PCR test (which would be by this time also be sensitive and more specific). The reports will allay all your fears about HIV and provide you the much needed piece of mind.

It is recommended that here after adhere to protected sex in future.

Good luck!

Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Is it possible to have white tongue after potential HIV exposure? Taken Nystatin 3 hours later
You mean cannot be an early symptom or MAY not be an early symptom. I have taken the DNA last Thursday , 10 days after latest exposure and awaiting results

I have also taken RNA test last thursday (10 days after last exposure) and awaiting results today or tomorrow.

Sorry I meant one RNA test, not DNA. I have heard its FDA approved.
Answered by Dr. S. Murugan 9 hours later

Pleased to answer your query.

As I mentioned in my previous answers based on my vast experience in this field of HIV, I haven't had or heard of any patients where oral thrush manifested as early manifestation of HIV. However in medicine no hard and fast rule applies, I used the word 'may not be' rather than 'cannot be'. The results of the PCR test will be confirmatory.

HIV RNA will be more useful to assess the prognosis and response to treatment as it denotes viral load whereas HIV DNA is more useful as a diagnostic one as it is very sensitive.

As you are already given the test and waiting for the results everything will be clear with the results. So we can close this conversation with this.

Good luck to you.

Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Is it possible to have white tongue after potential HIV exposure? Taken Nystatin 3 hours later
Just got my RNA test and came back negative. I am sure Iam gonna sleep good tonight. I took it at 10 days past exposure so it should be pretty conclusive right? No need to retest right?

Also, I want to thank you for your services. You gave me much peace of mind with your knowledge during this past sleepless week. You can't imagine how much I appreciate it.

Answered by Dr. S. Murugan 4 hours later

Congratulations! RNA PCR Test is the final verdict and highly reliable.

You can put the worries behind and enjoy the freedom from your tension. Avoid high risk sexual behaviour in future.

I was glad to be of help.

If you have no further queries, please close this discussion. Your reviews about this service would be much appreciated.

Best wishes.
Above answer was peer-reviewed by
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