Thrush: Treatment, symptoms, advice and help

About thrush

Thrush or candidiasis is an opportunistic benign fungal infection encountered most frequently in infants and children. Several species of the genus Candida may cause infections in humans, but Candida albicans is the usual causative agent.

Thrush: Incidence, age and sex

The disease is typically limited to infants and neonates, patients on antibiotics or steroids, and patients with endocrine disorders or underlying immune dysfunction. Children on inhaled steroids also have increased incidence of oral candidiasis.

Signs & symptoms of thrush: Diagnosis

On the mucosal surface of the oral cavity there are patches of pearly white pseudomembranes that resemble curds of milk. Removal of the pseudomembrane leaves a denuded red lesion. With oesophageal candidiasis, dysphagia and retrosternal pain may be presenting symptoms.

Vaginal candidiasis causes pruritus and a whitish, watery vaginal discharge. Typical thrush lesions may be visualized on the vaginal mucosa.

The diagnosis can be made from visual examination in most instances and can be confirmed by direct examination of materials scraped from the surface lesions.

Causes and prevention of thrush

Candida albicans is the usual causative agent. Some preventive measures include natural yoghurt and acidophilus capsules when taking antibiotics, prompt treatment of other types of candidiasis, quit smoking, good diabetic control, well-fitting dentures, good dental hygiene, regular dental checkups, reducing sugar in diet and preventive antifungals - in severe cases.

Thrush: Complications

Difficulty in feeding, inadequate nutrition, oesophageal candidiasis, throat thrush symptoms, spread of thrush to other areas and spread of thrush from infant's mouth to nursing mother's nipples/breasts.

Thrush: Treatment

Oropharyngeal candidiasis is treated with oral nystatin, 200,000 to 500,000 units every 4 to 6 hours, for 1 week or longer. Vaginal candidiasis is treated with clotrimazole or nystatin suppositories. Oesophageal, gastric, and intestinal candidiasis can be treated in the same manner as that used for treating oropharyngeal candidiasis, provided that the nystatin suspension is swallowed.