Whitish, cottage cheese-like material on the tongue.

THRUSH

Thrush is a common yeast infection that can occur on different parts of the body, and is caused by the overgrowth of Candida Albicans.

• 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), and iron-deficiency anemia
• Other candidal infections that affect the skin include chronic mucocutaneous candidiasis, neonatal candidiasis, congenital candidiasis and disseminated candidiasis.

Clinical

One sees a whitish, cottage cheese, plaque that is easily scraped away. Underneath, the mucosa is reddened and inflamed.

Treatment

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.

In the approriate situation, the iron level (e.g. ferritin) may be checked.

RegionalDerm

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