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.
Signs and symptoms of oral infection by Candida species may not be immediately noticeable but can develop suddenly and may persist for a long time. The infection usually appears as thick white or cream-colored deposits on mucosal membranes such as the tongue, inner cheeks, gums, tonsils, and palate. The infected mucosa may appear inflamed (red and possibly slightly raised) and sometimes have a cottage cheese-like appearance. The lesions can be painful and will become tender and often bleed if rubbed or scrapped. Cracking at the corners of the mouth, a cottony-like sensation inside the mouth, and even temporary loss of taste can occur.
In more severe cases, the infection can spread down the esophagus and cause difficulty swallowing – this is referred to as Esophageal candidiasis. Thrush does not usually cause a fever unless the infection has spread beyond the esophagus to other body parts, such as the lungs (systemic candidiasis).
In addition to the distinctive lesions, infants can become irritable and may have trouble feeding. The infection can be communicated during breast-feeding to and from the breast and the infant’s mouth repeatedly.
Oral candidiasis can be treated with topical anti-fungal drugs, such as nystatin, miconazole, Gentian violet 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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