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4.08 Oral Candidiasis (Thrush)


Presentation

An infant (usually with a concurrent diaper rash) will have white patches in his mouth, or an older patient (usually with poor oral hygiene, diabetes, a hematologic malignacy, some immunodeficiency or on antibiotic, cytotoxic or steroid therapy) will complain of a sore mouth and sensitivity to foods that are spicy or acidic. On physical examination, there are painless white patches in the mouth and and on the tongue which wipe off easily with a swab, leaving an erythematous base that may bleed. There may be intense dark red inflammation throughout the oral cavity. .

What to do:

Discussion

In the health newbor, thrush is a self-limited infection, but it should be treated to avoid feeding problems. In adults, oral candidiasis is found in a variety of acute and chronic forms. Localized erythema and erosions with minimal white exudate may be caused by candidal colonies beneath dentures and is commonly called "denture sore mouth." Maintenance prophylaxis may be prequired in patients with AIDS. Nystatin suspension has a high sugar content.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
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Michael Gillam, MD