If a patient has been on penicillin and presents with a sore tongue, what is the most appropriate first step?

If a patient has been on penicillin and presents with a sore tongue, what is the most appropriate first step?

• A. Perform a cytology smear
• B. Conduct a fungal test
• C. Prescribe additional antibiotics
• D. Refer to the emergency room

Answer: (B)

The most appropriate first step when a patient on penicillin presents with a sore tongue is to conduct a fungal test. This is particularly relevant because one of the common side effects of antibiotic use, including penicillin, is the development of oral thrush, which is a fungal infection caused by Candida species. Antibiotics can disrupt the normal flora of the mouth, allowing for an overgrowth of fungi. Performing a fungal test helps confirm the presence of this infection. Identifying a fungal infection is crucial because the management differs significantly from that of a bacterial infection. Once confirmed, appropriate antifungal treatment can be initiated, rather than prescribing additional antibiotics, which may exacerbate the problem by further disrupting the oral microbiome. Choosing a cytology smear may also provide diagnostic clarity, but it is typically not the first-line approach for suspected oral thrush. Immediate referral to an emergency room is unnecessary unless there are severe systemic symptoms or complications, and it is not the primary concern when dealing with a sore tongue in the context of antibiotic use.

The most appropriate first step when a patient on penicillin presents with a sore tongue is to conduct a fungal test. This is particularly relevant because one of the common side effects of antibiotic use, including penicillin, is the development of oral thrush, which is a fungal infection caused by Candida species. Antibiotics can disrupt the normal flora of the mouth, allowing for an overgrowth of fungi.

Performing a fungal test helps confirm the presence of this infection. Identifying a fungal infection is crucial because the management differs significantly from that of a bacterial infection. Once confirmed, appropriate antifungal treatment can be initiated, rather than prescribing additional antibiotics, which may exacerbate the problem by further disrupting the oral microbiome.

Choosing a cytology smear may also provide diagnostic clarity, but it is typically not the first-line approach for suspected oral thrush. Immediate referral to an emergency room is unnecessary unless there are severe systemic symptoms or complications, and it is not the primary concern when dealing with a sore tongue in the context of antibiotic use.