Candidiasis "oral thrush"

Candidiasis is a fungal infection due to any type of Candida (a type of yeast). When it affects the mouth, in some countries it is commonly called thrush.

More than 20 types of Candida can cause infection with "Candida albicans" being the most common.

Candida albicans is constituent of the normal oral microflora that rarely colonizes and infects the oral mucosa without predisposing factors

Signs and symptoms include white patches on the tongue or other areas of the mouth and throat. Very rarely, yeast infections may become invasive, spreading to other parts of the body .This may result in fevers along with other symptoms depending on the parts involved .

Risk factors

Infections of the mouth are most common among children less than one month old, the elderly, and those with weak immune systems. Conditions that result in a weak immune system include HIV/AIDS, the medications used after organ transplantation, diabetes, and the use of corticosteroids. Other risks include dentures, following antibiotic therapy, and breastfeeding.

Efforts to prevent infections of the mouth include the use of chlorhexidine mouthwash in those with poor immune function and washing out the mouth following the use of inhaled steroids. For infections of the mouth, treatment with topical clotrimazole or nystatin is usually effective. Oral or intravenous fluconazole, itraconazole, or amphotericin B may be used if these do not work.

Infections of the mouth occur in about 6% of babies less than a month old. About 20% of those receiving chemotherapy for cancer and 20% of those with AIDS also develop the disease. About three-quarters of women have at least one yeast infection at some time during their lives . Widespread disease is rare except in those who have risk factors.

Signs and symptoms of candidiasis

Signs and symptoms of candidiasis vary depending on the area affected. Most candidal infections result in minimal complications such as redness, itching, and discomfort, though complications may be severe or even fatal if left untreated in certain populations. In healthy (immunocompetent) persons, candidiasis is usually a localized infection of the skin, fingernails or toenails (onychomycosis), or mucosal membranes, including the oral cavity and pharynx (thrush),

In immunocompromised individuals, Candida infections in the esophagus occur more frequently than in healthy individuals and have a higher potential of becoming systemic, causing a much more serious condition, a fungemia called candidemia. Symptoms of esophageal candidiasis include difficulty swallowing, painful swallowing, abdominal pain, nausea, and vomiting.

Infection in the mouth is characterized by white discolorations in the tongue, around the mouth, and throat. Irritation may also occur, causing discomfort when swallowing

Thrush is commonly seen in infants. It is not considered abnormal in infants unless it lasts longer than a few weeks.

In oral candidiasis, simply inspecting the person's mouth for white patches and irritation may make the diagnosis. A sample of the infected area may also be taken to determine what organism is causing the infection.

Diagnosis of candidiasis

Diagnosis of a yeast infection is done either via microscopic examination or culturing. For identification by light microscopy, a scraping or swab of the affected area is placed on a microscope slide.

For the culturing method, a sterile swab is rubbed on the infected skin surface. The swab is then streaked on a culture medium. The culture is incubated at 37 °C (98.6 °F) for several days, to allow development of yeast or bacterial colonies. The characteristics (such as morphology and colour) of the colonies may allow initial diagnosis of the organism causing disease symptoms.

Scraping of white patches remove white pseudomembranous area and show underlying red area , by this sign we can differentiate it with other white lesions which will not be removed with swab scraping .

Oral lesions associated with candidiasis include

Oral pseudomonous candidiasis (thrush, oropharyngeal candidiasis)

Denture-related stomatitis— Candida organisms are involved in about 90% of cases , due to wearing dentures in conjunction with poor oral hygiene

Angular cheilitis— Candida species are responsible for about 20% of cases, mixed infection of C. albicans and Staphylococcus aureus for about 60% of cases .

Median rhomboid glossitis (central papillary atrophy)

atrophic glossitis

Treatment of candidiasis

Candidiasis is treated with antifungal medications; these include clotrimazole, nystatin, fluconazole, voriconazole, amphotericin B, and echinocandins. Intravenous fluconazole or an intravenous echinocandin such as caspofungin are commonly used to treat immunocompromised or critically ill individuals.

The 2016 revision of the clinical practice guideline for the management of candidiasis lists a large number of specific treatment regimens for Candida infections that involve different Candida species, forms of antifungal drug resistance, immune statuses, and infection localization and severity.Gastrointestinal candidiasis in immunocompetent individuals is treated with 100–200 mg fluconazole per day for 2–3 weeks.

Mouth and throat candidiasis are treated with antifungal medication. Oral candidiasis usually responds to topical treatments; otherwise, systemic antifungal medication may be needed for oral infections. Candidal skin infections in the skin folds (candidal intertrigo) typically respond well to topical antifungal treatments (e.g., nystatin or miconazole). For breastfeeding mothers topical miconazole is the most effective treatment for treating candidiasis on the breasts.Gentian violet can be used for thrush in breastfeeding babies.

Treatment typically consists of oral or intravenous antifungal medications.

👆 Diabetic mellitus and dental treatment protocol

Candidiasis "oral thrush"