instruction: hi doctor I need some advice on behalf of my mother who is 67 years old for the past 12 days my mother has been experiencing pain in the throat area feels like something is stuck vomiting mucous weakness body aches white tongue difficulty swallowing and vomiting feeling while talking and eating she vomits about twice a day she consulted an ent and internal medicine doctor ent dismissed her after nothing found in throat using a camera but the internal medicine doctor did some investigations results showed ti epithelial cells 20 25 hpf and pus cells 30 35 and ash 13 raised as well as candid albicans growth from a throat swab she has had this issue every few months and normally clears up on its own but this time it is very severe and not going away current medication cefotil cefuroxime 500 my and clavulanic acid 125 my gelora gel for oral thrush miconazole be motigut for vomiting 10mg thyearoxine 50 mug currently but internal medicine doctor asked to increase the dose to 5 tablets due to high ash urine culture was done and it was normal my query is whether this is a bad infection not bacterial but growth of esophageal candidiasis can be treated by antifungal therapy fluconazole no improvements are seen with many antibiotics oral thrush candid was found on initial appointments and also candid in throat swab is there any harm in trying a course of fluconazole she had a history of fungal infections in the throat which normally clear up on its own this time it seems much more serious if it is fine what dosage would you recommend and for what period
output: hello yes your mother is suffering from hypothyearoidism oral candidiasis ti urinary tract infection dysphagia oral candidiasis or oral thrush if not improved within five days after starting local antifungal then you may start oral antifungal medication you may use tablet af fluconazole 150 my once a day for one week but in case of old age people may feel nausea or vomiting for this drug then you can give iv fluconazole foran 100 my once a day for five days in old age vitamin b12 deficiency is also common so it may present like glossitis with pharyngitis take vitamin b12 injection weekly once you can give neurobion injection also use candid mouth paint for local application use tablet levosulfuride 25 my twice a day for nausea and vomiting at the same time check for serum electrolytes levels which may be altered in old age lead to vomiting you may give probiotics like capsule gut ok or sporulac sachets to increase the immunity levels and also prevent gut growth of fungus remaining medications you continue the same response to the treatment may take four to five days diabetic patients are more prone to oral candidiasis so check for blood sugar