THRUSH

General Information

DEFINITION--A common fungus infection of the mouth.

BODY PARTS INVOLVED--Mouth; gums; tongue; soft palate; cheeks; lips.

SEX OR AGE MOST AFFECTED--Newborns and infants, but may also affect older children and adults.

SIGNS & SYMPTOMS--

Patches appear in the mouth with the following characteristics:

• Patches are white to creamy yellow and slightly raised. They are similar to milk curds, but they don't wipe off.
• Patches are not painful unless they are rubbed off. Then they leave small, painful ulcers.
• The mouth is dry.

CAUSES--

A fungus called Candida albicans. It is usually present in small numbers in the mouth, but certain factors may cause it to multiply out of control:

• Treatment with antibiotics. This may upset the natural balance of organisms in the mouth and allow thrush to develop.
• Birth. Newborns may acquire the infection during passage through the birth canal, especially if the mother has a vaginal yeast infection. Thrush appears within hours or up to 7 days after birth.
• Aging. Older persons develop thrush because of lower natural resistance.

RISK INCREASES WITH

• Poor nutrition.
• Illness that has lowered resistance.
• HIV infection (thrush in adults is part of the criteria for diagnosis).
• Diabetes.
• Irritation from dentures.
• Immunosuppression due to illness or drugs.
• Chronic use of steroid medication (oral or inhaled).

HOW TO PREVENT

• Good oral hygiene.
• Avoid unnecessary antibiotics.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Scraping of the plaque and the material examined under a microscope.

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment if self-care is not successful.
• Treatment is aimed at improving the underlying condition that predisposes the patient to the infection and relieving the symptoms of thrush.

POSSIBLE COMPLICATIONS--Can spread to vagina, skin, larynx, gastrointestinal tract or respiratory system.

PROBABLE OUTCOME--Treatment usually clears this infection in 3 days. It is not dangerous or serious, but it has a tendency to recur.

How To Treat

GENERAL MEASURES---If an infant has the infection, boil bottle nipples separately for 20 minutes before the final sterilization.

MEDICATION--

• A dilution of hydrogen peroxide as a mouth rinse will soothe the discomfort.
• Your doctor may prescribe: A throat lozenge of clotrimazole dissolved in the mouth 5 times a day for 14 days. Nystatin suspension to be applied to the lesions. Oral ketoconazole for more severe disorder.
• Anticandidal creams to be applied under dentures or at the corners of the mouth.

ACTIVITY--No restrictions.

DIET--No changes in infants. Older children and adults should maintain an adequate fluid intake with milk, liquid gelatin, ice cream, custard, water, tea or other beverages and foods that are easy to swallow. Use a straw for drinking if the patches are painful.

Call Your Doctor If

• You or your child has symptoms of thrush.
• Signs of dehydration (sunken eyes, poor elasticity of the skin and lethargy) appear in a child.
• An infant fails to gain weight or an unexplained weight loss occurs in an older person.
• Fever develops.
• Lesions on the skin or vagina appear.
• Signs of secondary bacterial infection (pain, redness, tenderness, swelling) occurs in the mouth.