By Gary M. White, MD
The term thrush or pseudomembranous Candidiasis refers to candidal infection of the mouth. Infants and adults with a weakened immune system (e.g. by HIV, diabetes, age) are typically affected.
- Other predisposing factors include denture use, and omeprazole (a potent inhibitor of acid production by the stomach).
- Other candidal infections that affect the skin include chronic mucocutaneous candidiasis, neonatal candidiasis, congenital candidiasis and disseminated candidiasis.
- Iron-deficiency anemia predisposes to oral candidiasis [J Formos Med Assoc. 2016 Aug;115(8):619-27].
One sees a whitish, cottage cheese, plaque that is easily scraped away. Underneath, the mucosa is reddened and inflamed.
For infants, nystatin suspension painted on the lesions (e.g. 1 cc) QID x 7 days is usually sufficient. If the baby is breastfeeding, the same suspension may also be applied to mom's nipples several times a day. For adults and older children, clotrimazole troches dissolved in the mouth 5/day is effective. A single dose of fluconazole 150 mg is effective. It is also therapeutic if there is an associated candida esophagitis . The iron level (e.g. ferritin) should be measured.
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