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Ailmemts & Remedies Pediatric

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).

*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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Fungus on Skin

The word fungus conjures up visions of mold and dirty, damp unhygienic surroundings. Many of us may cringe at the thought of developing a fungal infection. But these infections are common and most people suffer from several attacks during the course of a lifetime.
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In babies, small curd-like white patches can form in the mouth. These are difficult to remove. If scraped off, a raw red area is exposed. This is commonly called “thrush” and is caused by a fungal specie called candida. It may occur if the child is bottle fed, uses a pacifier or has recently had a course of antibiotics. It may make the child irritable while feeding.

Oral thrush may occur in adults too if they have ill-fitting dentures, suffer from diabetes, have had a course of antibiotics, consumed steroids, are on anti-cancer drugs, are smokers, or are immuno compromised as a result of medicines or HIV infection.

In adults as well as children, oral thrush can be treated with applications of anti-fungal medication like clotrimazole two or three times a day. Dentures must be cleaned regularly. Feeding bottles and artificial nipples should ideally not be used. If thrush has occurred, they must be rinsed with a solution of equal parts of vinegar and water and air dried prior to sterilisation.

Candida and some bacteria like lactobacillus normally live in perfect harmony in the vagina. The lactobacillus produces acid, which prevents the overgrowth of candida. If this balance is disrupted, candida can overgrow, resulting in infection. Imbalance occurs as a result of diabetes, pregnancy, hormonal tablets, antibiotics, steroids or immuno suppression. Frequent douching or using “feminine hygiene sprays” may also lead to infection. Vaginal fungal infections owing to candida affect almost all women. It causes redness, an uncontrollable itch and an odourless white discharge.
You may click to see :Natural solutions for Candida Albicans: Candida diet
Treatment involves the application of creams or insertion of vaginal tablets for one, three or six days. Sometimes oral medicines have to be taken. The bacteria-fungus balance in the vagina can be restored by eating lactobacillus. This is found in homemade curd. A tablespoon a day usually restores the balance.

Men can develop candida infection on the foreskin, especially if they are diabetic. The skin is itchy and may develop fissures. Topical anti-fungal creams work well.

Men are also prone to developing “jock itch” (or dhobi’s itch), an infection of the groin area where the skin is usually warm and moist. Infection is precipitated by wearing tight undergarments, or not changing sweaty exercise clothes promptly. Treatment involves bathing regularly, wearing loose-fitting clothes and application of anti-fungal creams.

The warm moist areas between the toes may also develop a fungal infection called Tinea pedis or athlete’s foot. It causes itching, burning, cracking and at times blisters. It occurs with wearing damp socks and tight airless shoes, especially of a non-porous material like plastic.

To prevent Tinea pedis, the feet need to be aired and socks changed regularly. Once infection has developed, the feet should be soaked in equal quantities of water and vinegar for 10 minutes a day. After wiping them dry, an anti-fungal cream needs to be applied. The infection may take two to four weeks to clear up.

The warm and moist areas of the inner thighs, genitalia, armpits, under the breasts, and waist may also develop fungal infection and become red, itchy, oozy and sore. This is common in overweight individuals and those with diabetes. Treatment is by bathing regularly and keeping the area dry. Talcum powder aggravates the problem. Instead, the area should be patted dry after a bath and a combination of a “diaper rash” cream containing zinc oxide and an anti-fungal medication must be applied.

Toe nails and fingernails can also get infected by fungus. The nail then hurts, breaks easily and becomes discoloured. This occurs if the nails are constantly exposed to moisture or are immersed in water, if non-absorbent socks or shoes are used, or if the person has diabetes. Treatment is with applications and medications for one and a half to six months. Soaking the feet in a solution of one part vinegar and two parts water for 10 minutes daily and then applying Vicks VapoRub has anecdotally been shown to be effective.

The outer layers of the skin can develop scaly white patches of Tinea versicolor infection. Moist climates, sweating, humidity and hormonal changes have been blamed for this. The infection responds well to Selinium sulphide (Selsun) or Ketoconazole (Nizral) shampoo.

Ringworm causes round, hairless patches on the scalp and skin. They are contagious and spread by contact with infected humans or animals. Medicines have to be taken for six weeks. Topical agents are not effective.

Source : The Telegraph (Kolkata, India)

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