Oral Candidiasis - Thrush Mouth

Oral candidiasis, popularly called thrush, is an infection of the oropharynx caused by the fungus Candida albicans. Contrary to what many people think, candidiasis in the mouth is not a problem unique to patients with HIV. It can actually be one of the signs of AIDS, but often also arise frequently in children, the elderly and people with some alteration of the immune system.

Oral candidiasis
Oral candidiasis

What is thrush

Have small colonies of Candida fungi living on our skin, mouth and digestive tract is perfectly normal. When our immune system is intact, it is fully capable of keeping the population of the fungus under control, preventing that it might cause any kind of disease.

However, whenever there is some weakness in our immune system, the population of Candida albicans can grow quickly and become able to break into the deeper layers of the skin, causing inflammation. The greater the degree of immunosuppression of the patient, it is more aggressive and dangerous infection with candida fungus may be invasion of blood, heart , or central nervous system.

Thrush in the mouth is a mild form of candidiasis, which affects mainly the mucous membrane of the tongue and the inside of the cheek. To have oral candidiasis is not necessary to be a significant immunosuppression.

The vast majority of cases of thrush is caused by Candida albicans , but other species of candida can also be responsible, such as Candida glabrata, Candida krusei or Candida lusitaniae.

Risk factors for oral candidiasis

Oral candidiasis can occur in anyone, but it is much more common in those with the following characteristics:
  • Older age
  • Children in the first year of life
  • Pregnant
  • Use denture
  • Recent antibiotic use
  • Prolonged use of corticosteroids
  • Use of immunosuppressive drugs
  • HIV positive
  • Poorly controlled diabetes
  • Being under chemotherapy or radiotherapy
  • Smokers
  • People with xerostomia (dry mouth)
  • Hospitalization
  • Malnutrition
  • Heavy drug user

Symptoms of candidiasis in the mouth

Oral lesions caused by Candida albicans are white plates, with half creamy appearance or type ricotta cheese, affecting language, inner wall of the cheeks, and sometimes the palate (roof of the mouth), gums or tonsils. The oral candidiasis lesions may appear small and asymptomatic, going unnoticed for some time. The trend, however, is that they evolve and become easily visible and symptoms, such as pain and diminished taste. A cotton mouth feel is also thrush symptom quite often.

In the elderly who use dentures, these white lesions that are typical of candidiasis may not be present, with only intense redness in the gums under the dentures. The presence of angular cheilitis, popularly known as boqueira, is also very common.

In babies, the injury of candidiasis may be confused by mothers with milk remains in the mouth. It is important to know that the milk disappears spontaneously after some time, and by passing a gauze on the tongue, it comes out easily. Already candidiasis, white boards are well attached to the mouth. When trying to scrape them, there may be bleeding and the mucosa underneath is sore and reddened well.

In more serious cases, candidiasis can develop into the larynx and / or esophagus, causing symptoms such as hoarseness and pain / difficulty swallowing food. Esophageal candidiasis is usually a more severe immunosuppression signal, being very common in patients with AIDS.

The diagnosis of oral candidiasis is simple. In many cases, the damage is typical and the patient's history indicating the presence of an immunosuppressive factor facilitates diagnosis. If the clinician wants a confirmation, he can scrape a piece of injury and lead to the microscope to identify the presence of yeast.

Treatment of oral candidiasis

The treatment of oral candidiasis can be done with mouthwashes and swallowing nystatin 4 times per day for at least 1 week. If there is no improvement, indicates the use of fluconazole tablet for 1 to 2 weeks. This last treatment success rate is above 90%.

To assist in the treatment is indicated cessation of smoking, and regularly brushing teeth adequately (but avoid the use of mouthwash) and avoid alcoholic beverages and foods high in sugars. unsweetened yogurt help restore the natural flora of the mouth bacteria, increasing competition for food, which inhibits the proliferation of Candida.

In infants, it is important to clean and pacifiers, cutlery and bottles after use to prevent the colonization of fungi. By the same token, an antifungal cream should be applied to the mother's nipple after proper cleaning.

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