Tuesday, September 1, 2009

Oral candidiasis

Oral candidiasis (also known as "Thrush) is an infection of yeast fungi of the genus Candida on the mucous membranes of the mouth. 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.


Symptoms

Oral infections by Candida species usually appear as thick white or cream-coloured deposits on mucosal membranes. The infected mucosa of the mouth may appear inflamed (red and possibly slightly raised). In babies the condition is termed thrush. Adults may experience discomfort or burning.


Special risk groups

  • 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 which 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.
  • People with fresh oral piercings coming into regular contact with yeast.[citation needed]
  • Denture users.
  • Smokers.

Thrush and breastfeeding

Because of the increased use of antibiotics in laboring women to reduce the transmission of Group B streptococcal infection to the infant, thrush has become more prevalent. Symptoms include an oral rash in the infant's mouth, a diaper rash that does not heal with conventional diaper rash treatments and ointments, or burning, painful nipples of the breastfeeding mother.

The rash and pain experienced by the mother can range from severe to mild and may complicate breastfeeding. Treatments include good hygiene of the nipples; oral probiotics containing L. acidophilus; and over-the-counter antifungal cream containing nystatin, clotrimazole, or miconazole on the nipples. Some clinicians recommend washing the cream off before breastfeeding.


Treatment

Oral candidiasis on the tongue and soft palate.

Oral candidiasis can be treated with topical anti-fungal drugs, such as nystatin, miconazole or amphotericin B. Topical therapy is given as an oral suspension which is washed around the mouth and then swallowed by the patient.

Patients who are immunocompromised, either with HIV/AIDS or as a result of chemotherapy, may require systemic treatment with oral or intravenous administered anti-fungals.



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