Thrush (oral candidiasis) is an infection caused by the overgrowth of the fungus Candida albicans in the mouth. Normally, Candida is a harmless inhabitant of the oral cavity, but it can multiply excessively when the immune system is weakened or the natural balance of microorganisms is disrupted. Factors that contribute to thrush include antibiotic use, diabetes, immunosuppressive medications, and conditions like HIV/AIDS. The overgrowth of Candida leads to white patches on the mucous membranes of the mouth, which can cause discomfort and difficulty swallowing.
Clinical Evaluation
Patient History: Review of symptoms and any underlying conditions or medications that may predispose to fungal overgrowth.
Physical Examination: Inspection of the mouth for characteristic white patches on the tongue, inner cheeks, gums, and throat. The patches may be painful and can bleed when scraped.
Laboratory Tests
Microscopic Examination: Scraping of the white patches for examination under a microscope to confirm the presence of Candida.
Culture: In some cases, a culture may be taken to identify the specific strain of Candida and determine its sensitivity to antifungal medications.
White, creamy lesions on the tongue, inner cheeks, gums, tonsils, or throat.
Redness and soreness inside the mouth and throat.
Cracking and redness at the corners of the mouth.
Loss of taste or a cottony feeling in the mouth.
Pain while eating or swallowing.
In severe cases, the infection may spread to the esophagus, causing more serious symptoms like difficulty swallowing and chest pain.
Treatment for Thrush focuses on eliminating the Candida infection and addressing underlying causes to prevent recurrence:
Antifungal Medications: Oral antifungal agents such as nystatin, clotrimazole, fluconazole, or itraconazole are commonly used. These may be in the form of lozenges, tablets, or liquid suspensions.
Topical Antifungals: Applied directly to the affected areas for localized treatment.
Good Oral Hygiene: Regular brushing and flossing, along with cleaning of dentures or other oral appliances, to reduce fungal load.
Addressing Underlying Conditions: Managing diabetes, adjusting medications, or boosting immune function if possible.
Dietary Adjustments: Reducing sugar intake, as high sugar levels can promote fungal growth.
Probiotics: Taking probiotic supplements or eating yogurt with live cultures to help restore the natural balance of microorganisms in the mouth and gut.