• Knowledgebase: Information on Specific Illnesses

    Here you will find discussions of specific illnesses and their management.

    64. Thrush - Top

    Definition
    A disorder caused by infection of the mouth with the fungus (yeast) Candida albicans.

    Causes, Incidence and Risk Factors
    The mouth normally contains many microorganisms. One of these normal microorganisms is the fungus Candida albicans, which is the same fungus associated with vaginal yeast infections or other Candida infections. The growth of Candida is normally kept under control by the presence of normal bacteria.
    Uncontrolled overgrowth of Candida in the mouth may be caused by factors that reduce the natural resistance, such as illness, stress, long-term use of corticosteroids or medications that suppress the immune system, and immune disorders such as AIDS. It may also be caused by conditions that upset the balance of normal microorganisms in the mouth. This is most commonly associated with use of antibiotics but it may also occur with uncontrolled diabetes mellitus and with the hormonal changes associated with pregnancy or the use of birth control pills.
    Oral thrush is most common in infants and toddlers, in the elderly, and in people who are debilitated or whose immune system has been suppressed by disease or medical treatments. Long-term use of antibiotics, corticosteroids, and anti-cancer medications increases the risk. Xerostomia (dry mouth) also increases risk.


    Symptoms
    ulcer/skin lesion in the mouth (usually on the tongue or inner cheeks)
    painful
    slightly raised area
    creamy white appearance
    may appear curd-like ("cottage cheese" appearance)
    dry mouth
    Signs And Tests
    An examination of the mouth by the health care provider or dentist shows distinctive lesions of the mouth, tongue, or cheeks. Lesions are easily brushed away revealing a reddened, tender area that may bleed slightly.
    A microscopic examination of tissue from a lesion confirms Candida infection.


    Treatment
    The goal of treatment is to control the rapid growth of Candida. Antifungal medications such as nystatin, clotrimazole, miconazole, etc. are given for 7 to 10 days. Underlying conditions/disorders should be identified and treated.
    Good oral hygiene is important to aid healing. Patches may be gently brushed off with the toothbrush. Warm salt water rinses (1/2 teaspoon of salt in one cup of water) may be soothing.

    Expectations (Prognosis)
    Oral thrush may be painful but is rarely serious. It can interfere with eating because of the discomfort. The infection is usually controlled with treatment, but it may recur. Thrush may spread to the palate, tongue, cheeks, or throat. Other spread of the infection is uncommon but it may occur.

    - Updated: March 5, 2001

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    • James L Horwitz, MD

    David C. Thomas, MD

    Barbara Lindberg, PNP