Oral candidiasis (Thrush)


Oral candidiasis, also commonly referred to as oral thrush, is a fungal infection caused mainly by Candida albicans, which affects mucosal membranes of the oral cavity and the tongue.

Appears as white plaques overlying erythematous areas on the mucosa of the buccal mucosa, palate or oropharynx.

Removing white material may reveal underlying ulcerations.

A superficial fungal infection of the oral mucosa.

Candida albicans is usually the cause of the infection and can be isolated in approximately 50% of healthy adults.

C. albicans accounts for approximately 95% of oral thrush cases.

Risk is increased by local resistance, immunocompromised state and uncontrolled systemic disease.

Decreased local resistance is present with poor oral hygiene, dentures, xerostomia, and recent antibiotic therapy that can alter than normal competitive oral bacteria.

The presence of local factors, and a systemic process that causes immunosuppression or a constitutional compromise, dramatically increases the risk of infection: corticosteroid therapy, severe anemia, diabetes mellitus, and AIDS.

Associated with 4 clinical appearances: pseudomembrane, erythematous or atrophic form, fissure formation, and a hyperplastic form.

Often more than one type of lesion is present simultaneously in different areas of the mouth.

Associated, usually with little discomfort or mild burning sensation.

Process may be acute, chronic or cyclic.

Antifungal therapy is effective, but recurrences or chronic subclinical course can be seen if the predisposing condition is not improved.

Asymptomatic disease may not require therapy.

Treatment options include clotrimazole or nystatin locally.

Systemic agents like antifungal drugs ketocanozole or fluconazole may be alternatives for patients who cannot manage topical treatment or who are severely immunocompromised.

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