Fungal infection in groin area,anal itching and discomfort, burning sensation on tongue, strange taste in mouth

Professional Assessment: The constellation of symptoms strongly suggests a systemic candidiasis presentation, with multiple site involvement (oral thrush and genital/perianal candidiasis) being particularly concerning in an elderly male patient of 89 years. The pathophysiological mechanism likely involves age-related immunosenescence, reduced salivary flow, and possible underlying conditions such as diabetes mellitus or recent antibiotic use, which create favorable conditions for fungal overgrowth. Given the patient's advanced age and male gender, this presentation warrants careful evaluation for underlying immunocompromised states, including undiagnosed diabetes, malignancy, or HIV infection, as these symptoms are less common in elderly males without predisposing factors. Additional testing should include comprehensive metabolic panel, HbA1c, HIV screening, and oral/genital fungal cultures, with particular attention to species identification and antifungal susceptibility given the risk of resistant strains in elderly patients with possible previous antifungal exposure.

For the fungal infection symptoms affecting multiple areas, use an oral antifungal medication like Fluconazole (150mg single dose) combined with topical antifungal cream containing Clotrimazole 1% for the groin and anal area, applying 2-3 times daily for 2 weeks. For oral symptoms, use Nystatin oral suspension (swish and swallow 4 times daily) and maintain strict oral hygiene with alcohol-free antimicrobial mouthwash. Keep affected areas dry, wear loose cotton underwear, and avoid hot/spicy foods until symptoms resolve. For additional treatment recommendations, ask in the chat.