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Alternative Names Return to topCandidiasis - oral; Oral thrush
Definition Return to topThrush is a yeast infection of the mucous membranes of the mouth and tongue.
Causes Return to top
Thrush is caused by forms of a fungus called Candida. This organism lives in your mouth and is usually kept in check by healthy organisms that also live there. However, when your resistance to infection is low, the fungus can grow, leading to lesions in your mouth and on your tongue.
The following can lessen your resistance to infection and increase your chances of getting thrush:
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.
Symptoms Return to top
Thrush appears as whitish, velvety lesions in the mouth and on the tongue. Underneath the whitish material, there is red tissue that may bleed. The lesions can slowly increase in number and size.
If you are immunocompromised (for example, you are HIV positive or receiving chemotherapy), the infection can spread to other organs, such as the esophagus (causing pain with swallowing), or throughout your body, which can be deadly.
Exams and Tests Return to top
Your doctor or dentist can almost always diagnose thrush by looking at your mouth and tongue. These fungal lesions have a distinct appearance. If not entirely clear, one of the following tests may be performed to look for the candida organisms:
Treatment Return to top
For thrush in infants, treatment is often NOT necessary. It generally resolves on its own within two weeks.
There are two goals when treating oral thrush in adults. The first is to improve your immune system's ability to function. For example, in diabetics, good control of diabetes may be enough to clear the infection without other treatment.
The second is to directly treat the infection. For this purpose, your doctor may prescribe an antifungal mouthwash or lozenges to suck on. These 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 ketoconazole (Nizoral) or fluconazole (Diflucan).
Outlook (Prognosis) Return to top
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.
Possible Complications Return to top
Candida can spread throughout your body, causing infection in your esophagus (esophagitis), brain (meningitis), heart (endocarditis), joints (arthritis), or eyes (endophthalmitis).
When to Contact a Medical Professional Return to top
Call your doctor if:
Prevention Return to top
If you have frequent outbreaks of thrush, your doctor may recommend taking antifungal medication on a regular basis to avoid recurrent infections.
If an infant with thrush is breastfeeding, talk to your doctor about ways to prevent future infections, such as an antifungal medication. Sterilize or discard any pacifiers. For bottle-fed babies with thrush, discard the nipples and buy new ones as the baby's mouth begins to clear.
To prevent spread of HIV infection, follow safe sex practices and universal precautions when working with blood products.
References Return to top
Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 22 ed. Philadelphia, Pa: Saunders; 2004.
Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, MO: Mosby; 2002.
Mandell GL, Bennett JE, Dolin R, eds. Principles of Infectious Diseases. 5th ed. New York, NY: Churchill Livingstone, 2000.Update Date: 7/25/2007 Updated by: Kenneth M. Wener, MD, Department of Infectious Diseases. Lahey Clinic, Burlington, MA. Review provided by VeriMed Healthcare Network.