Oral thrush

 

Alternative Names: Candidiasis – oral; Oral thrush; Fungal infection – mouth; Candide – oral

Definition:
Oral thurs  is an infection of yeast fungi of the genus Candida on the mucous membranes of the mouth and tongue. It is frequently caused by Candida albicans, or less commonly by Candida glabrata or Candida tropicalis. Oral thrush may refer to candidiasis in the mouths of babies, while if occurring in the mouth or throat of adults it may also be termed candidosis or moniliasis…

 

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Although oral thrush can affect anyone, it’s more likely to occur in babies and people who wear dentures, use inhaled corticosteroids or have compromised immune systems. Oral thrush is a minor problem if you’re healthy, but if you have a weakened immune system, symptoms of oral thrush may be more severe and difficult to control.

Symtoms:
Signs and symptoms of oral infection by Candida species may not be immediately noticeable but can develop suddenly and may persist for a long time. The infection usually appears as thick white or cream-colored deposits on mucosal membranes such as the tongue, inner cheeks, gums, tonsils, and palate. The infected mucosa may appear inflamed (red and possibly slightly raised) and sometimes have a cottage cheese-like appearance. The lesions can be painful and will become tender and often bleed if rubbed or scraped. Cracking at the corners of the mouth, a cottony-like sensation inside the mouth, and even temporary loss of taste can occur.

In more severe cases, the infection can spread down the esophagus and cause difficulty swallowing – this is referred to as Esophageal candidiasis. Thrush does not usually cause a fever unless the infection has spread beyond the esophagus to other body parts, such as the lungs (systemic candidiasis).

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In addition to the distinctive lesions, infants can become irritable and may have trouble feeding. The infection can be communicated during breast-feeding to and from the breast and the infant’s mouth repeatedly

Causes:
Thrush is caused by forms of a fungus called Candida. A small amount of this fungus lives in your mouth most of the time. It is usually kept in check by your immune system and other types of germs that also normally live in your mouth.

 

However, when your immune system is weaker, the fungus can grow, leading to sores (lesions) in your mouth and on your tongue. The following can increase your chances of getting thrush:

•Taking steroid medications
•Having an HIV infection or AIDS
•Receiving chemotherapy for cancer or drugs to suppress your immune system following an organ transplant
•Being very old or very young
•Being in poor health
Thrush is commonly seen in infants. It is not considered abnormal in infants unless it lasts longer than a couple of weeks.

Candida can also cause yeast infections in the vagina.

People who have diabetes and had high blood sugar levels are more likely to get thrush in the mouth (oral thrush), because the extra sugar in your saliva acts like food for Candida.

Taking high doses of antibiotics or taking antibiotics for a long time also increases the risk of oral thrush. Antibiotics kill some of the healthy bacteria that help keep Candida from growing too much.

People with poorly fitting dentures are also more likely to get thrush.

Risk Factors:
*Newborn babies.

*Diabetics with poorly controlled diabetes.

*As a side effect of medication, most commonly having taken antibiotics. Inhaled corticosteroids for treatment of lung conditions (e.g., asthma or COPD) may also result in oral candidiasis: the risk may be reduced by regularly rinsing the mouth with water after taking the medication.

*People with an immune deficiency (e.g. as a result of AIDS/HIV or chemotherapy treatment).

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*Women undergoing hormonal changes, like pregnancy or those on birth control pills.

*Denture users.

*Tongue piercing

Complications:
Oral thrush is seldom a problem for healthy children and adults, although the infection may return even after it’s been treated. For people with compromised immune systems, however, thrush can be more serious.

If you have HIV, you may have especially severe symptoms in your mouth or esophagus, which can make eating painful and difficult. If the infection spreads to the intestines, it becomes difficult to receive adequate nutrition. In addition, thrush is more likely to spread to other parts of the body if you have cancer or other conditions that weaken the immune system. In that case, the areas most likely to be affected include the digestive tract, lungs and liver.

Diagnosis;
Oral thrush can usually be diagnosed simply by looking at the lesions, but sometimes a small sample is examined under a microscope to confirm the diagnosis.

In older children or adolescents who have no other identified risk factors, an underlying medical condition may be the cause of oral thrush. If your doctor suspects that to be the case, your doctor will perform a physical exam as well as recommend certain blood tests to help find the source of the problem.

If thrush is in your esophagus
Thrush that extends into the esophagus can be serious. To help diagnose this condition, your doctor may ask you to have one or more of the following tests:

*Throat culture. In this procedure, the back of your throat is swabbed with sterile cotton and the tissue sample cultured on a special medium to help determine which bacteria or fungi, if any, are causing your symptoms.

*Endoscopic examination. In this procedure, your doctor examines your esophagus, stomach and the upper part of your small intestine (duodenum), using a lighted, flexible tube with a camera on the tip (endoscope).

Treatment:
For thrush in infants, treatment is often NOT necessary. It generally gets better on its own within 2 weeks.

If you develop a mild case of thrush after taking antibiotics, eating yogurt or taking over-the-counter acidophilus capsules can help.

Use a soft toothbrush and rinse your mouth with a diluted 3% hydrogen peroxide solution several times a day.

Good control of blood sugar levels in persons with diabetes may be all that is needed to clear a thrush infection.

Your doctor may prescribe an antifungal mouthwash (nystatin) or lozenges (clotrimazole) to suck on if you have a severe case of thrush or a weakened immune system. These products are usually used for 5 – 10 days. If they don’t work, other medication may be prescribed.

If the infection has spread throughout your body or you have HIV/AIDS, stronger medications may be used, such as fluconazole (Diflucan) or ketoconazole (Nizoral).

Prognosis:
Thrush in infants may be painful, but is rarely serious. Because of discomfort, it can interfere with eating. If it does not resolve on its own within 2 weeks, call your pediatrician.

In adults, thrush that occurs in the mouth can be cured. However, the long-term outlook is dependent on your immune status and the cause of the immune deficit.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000626.htm
http://en.wikipedia.org/wiki/Oral_candidiasis
http://www.bbc.co.uk/health/physical_health/conditions/oralthrush2.shtml
http://www.mayoclinic.com/health/oral-thrush/DS00408

http://www.nlm.nih.gov/medlineplus/ency/imagepages/17284.htm

http://www.clivir.com/lessons/show/yeast-infection-in-mouth-and-throat.html

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