Yeast issues?

[Hickory14]

Hi Doctor,

Intermittently for the last few months I've been getting a patch on my tongue where there is no papillae. It comes and goes, varying in size each time and causes me no other issues. I did a lot of research on this and have narrowed it down to a condition called median rhomboid glossitis (MRG); experts in the medical community believe it is caused by Candida even though the condition looks nothing like thrush. As for me, I am in 100% good health. My annual bloodwork is immaculate and I am STD free. At my last physical I showed my doctor and she dismissed it quickly saying it looked like a burn or that it was probably irritated by something acidic I had been eating. This is not the case because I have changed my dental hygiene practices to phase out mouthwash and have been avoiding acidic foods.

I have a boyfriend now and a few weeks ago when we first started sleeping together we were doing it (protected) quite a lot. A few days later he told me that he had an STD scare because he had blister like cracks on his penis that he had never had before. He went to his doc who visibly examined him and said it was not an STD. He then ran an STD test and all results for STDs came back negative. A few days after he went to the doc I got my first yeast infection of my life. My doc told me it was likely due to too much sex or to a reaction to the condom. So now to the crux of my question....

I'm starting to worry that perhaps what my boyfriend had on his penis was a yeast infection. Is it possible that this MRG on my tongue (yeast?) could have been transmitted yeast to his penis during oral sex? I read that it's rare for a circumcised guy to get a yeast infection on his penis and he did see a doc who I would think would have noticed the yeast infection but still I am concerned. Any advice?

I even did that "spit test" into a glass of water to test for oral yeast and it definitely appears like I have yeast in my saliva. Again, it looks nothing like thrush.

[Edward W Hook, MD]

Thaks for the follow-up.  Indeed, it may be geopgraphic tongue.  If it continues to be a problem for you may wish to discuss it with a dermatologist. EWH

[Edward W Hook, MD]

Welcome to our Forum. Your situation and questions are both interesting and challenging.  With all due respect to your own doctor, MRG is well described but not well known by persons who are not specialists in relate areas (i.e. dermatologists, STD specialists, etc).  If you were my patient, I would treat you (and perhaps your BF with fluconazole as a "therapeutic trial".  I bet it would be helpful.

Regarding your BF's skin issues, there are certainly instances in which yeast infections have been transmitted from partner to partner in the course of sexual exposure (genital, oral, other), leading to a variety of manifestations.  Sometimes these manifestations are not "classical" and they are not encountered all that commonly by general practitioners.

I hope this helps.  I would treat you and your BF with fluconazole if I were your doctors and see what happens.  EWH

[Hickory14]

Thanks again, Dr. Hook.
Day 5 of the nystatin and still no change so I don't think it is yeast after all.
I'll continue to finish out the medication but I am starting to this that maybe it is geographic tongue and not MRG. I have environmental allergies and mild psoriasis and I know GT is often associated with both of these conditions. The therapeutic trial was worth it though and I feel better knowing that it likely isn't yeast after all.

[Edward W Hook, MD]

Yes it should.  Fluconoazole might work better.  EWH

[Hickory14]

Thank you. My doc took another look and said that she still does not believe the glossitis is being caused by yeast but just in case she put me on nystatin oral solution. Been on it for about 24 hours so far and am not seeing a difference yet. If the MRG is being caused by yeast then the Nystatin oral solution should improve it, correct?

Thanks again.

[Edward W Hook, MD]

You are correct that BC pills can increase yeast infections in some women.  So can diabetes and taking antibiotics.  Despite that, most persons with yeast infections do not have such risk factors.  I would discuss this with your doctor.  EWH

[Hickory14]

Doctor,

Thanks for the information. Should I be concerned about another underlying health issue?
My only risk factor appears to be birth control pills. I have read that hormonal changes from BC pills can affect yeast growth. Otherwise, I cannot think of any other reason why this would be happening as I have made no major dietary changes and am in great health.

Also, do you think the fluconazole will knock it out once and for all?

Thanks again