Thrush (Oral Candidiasis)

Who's At Risk?

Thrush is very common in infants. Adults who develop thrush include:

• People with diabetes or other glandular (endocrine) disorders
• Denture wearers
• People taking antibiotics
• Persons undergoing chemotherapy
• Drug users
• People with poor nutrition
• Persons who have an immune deficiency, such as HIV
• People who use inhaled steroids for certain lung conditions
• Pregnant women or women on birth control pills

Signs & Symptoms

Thrush may appear as white or pale yellow spots on the inner surfaces of the mouth and throat, the tongue, and the lips. It may resemble cottage cheese or milk curds. However, scraping off these membranes may be difficult and may leave slightly bleeding sores.

Thrush may be associated with a burning sensation in the mouth or throat.

Self-Care Guidelines

Thrush may make eating and drinking uncomfortable, and people with thrush may become dehydrated. It is important to maintain good nutrition and hydration while infected with thrush.

Thrush needs medications prescribed by a health care practitioner.

Treatments

Although meticulous oral hygiene practices must be followed, treatments center on killing the overgrown yeast with anti-fungal medications.

• Nystatin – This medicine must come into contact with the yeast in order to kill it. Nystatin comes in a suspension, or liquid, and in a lozenge, also called a troche. The suspension is swished around the mouth and then swallowed. The lozenge dissolves in the mouth. Both the suspension and the lozenges are used several times a day until the lesions are completely gone.
• Amphotericin B suspension – The suspension is swished and swallowed several times a day until complete resolution of the lesions.
• Clotrimazole lozenge – The lozenge is dissolved in the mouth several times a day until the lesions have disappeared entirely.
• Fluconazole pill – This medication is swallowed once daily for 5–10 days.

Visit Urgency

Thrush requires prescription medication after a quick visit to the physician. People with an immune system deficiency need even prompter and more aggressive treatment to make certain that the yeast does not enter the bloodstream or infect other organs. If the white or yellow membranes of thrush are accompanied by fever, chills, vomiting, or generalized illness, more immediate medical attention is warranted.

Trusted Links

• MedlinePlus: Yeast Infections
• Clinical Information and Differential Diagnosis of Candidiasis, Oral (Thrush)

References

Bolognia, Jean L., ed. Dermatology, pp.837, 1095, 1096, 1185. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed, pp. 2013. New York: McGraw-Hill, 2003.