(PDF) Oral Thrush in an Infant: A Case Report with Treatment Modalities

Nystatin preparations should also be held in the mouth for as long as possible - they are broken down as soon as they reach the stomach.

It may be possible to alter one or more of the situations mentioned above to help prevent further bouts of oral thrush. Medications like antibiotics, steroids and immunosuppressants in the treatment of malignancies are all also causative factors of the occurrence of oral thrush. They can be found in certain dietary supplements and some brands of yogurt that contain live bacterial cultures. An infection of the fungus that creates oral thrush can be passed between infants and breastfeeding mothers. Complications arising from oral thrush in children or adults are rare, however if an infection fails to respond to treatment, or if the child or adult falls into any of the categories listed above, you should talk to your pharmacist or doctor for further advice. This treatment usually involves using an antifungal mouth rinse or lozenges. This can cause nipple redness and pain.

The doctor may recommend other courses of action if necessary, depending on the underlying cause of the condition, such as recommending better fitting dentures, a modification of medicines for diabetes, or referral for further investigation.

If the thrush doesn’t respond to topical treatment, your healthcare provider will likely switch treatment to an antifungal pill. Oral thrush most often occurs in infants and toddlers. At very young ages, the immune system is yet to develop fully and there is no individual immune response to candida species,[9] an infants antibodies to the fungus are normally supplied by the mother's breast milk.

When your immune system is working properly, beneficial bacteria in your body help keep C. November 19, 2020; Accessed: If you see any signs or experience any symptoms of thrush, see your doctor right away so that you can get treatment and quickly restore the natural balance to your system.

Your healthcare provider will take your medical history.

Aspirin Burn

In babies, thrush is usually diagnosed on the basis of the clinical picture. This refers to a group of rare syndromes characterized by chronic candidal lesions on the skin, in the mouth and on other mucous membranes (i. )The infant may refuse to eat, which can be mistaken for lack of hunger or poor milk supply. Dominguez SR, Levin MJ (2020).

Left unchecked by antifungal drugs it can actually become several millimeters thick.

How to Prevent Thrush

Other antifungal preparations based on an ingredient called nystatin can be prescribed by a doctor for oral thrush which is resistant to non-prescription treatments. Disruption to any of these local and systemic host defense mechanisms constitutes a potential susceptibility to oral candidiasis, which rarely occurs without predisposing factors. 10 years of systematic review and meta-analysis from sub-Saharan Africa.

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Oral or intravenously administered antifungals may be the choice for patients with weakened immune systems. For example, adults are more likely to develop thrush if they have a history of certain medical conditions, medical treatments, or lifestyle habits that weaken their immune system. Methylene blue oral is an antiseptic that is reported to help relieve oral candidiasis. Therefore, accurate identification of the causative Candida species by culturing and sensitivity tests is important for the appropriate selection of the antifungal therapy. The tests will look for certain conditions linked to oral thrush, such as diabetes and nutritional deficiencies. Marazzi /Photo Researchers, Inc.

Who can get thrush and is it contagious (pass from person to person)?

Sometimes they may also recommend blood tests to look for certain conditions associated with oral thrush, such as diabetes and nutritional deficiencies. Lewis MAO, Williams DW. While thrush can affect anyone, babies under 1 month old, toddlers, older adults and people with weakened immune systems (where symptoms can be harder to control) are at more risk. In adults, thrush can cause an uncomfortable burning sensation in the mouth and throat, a bad taste in the mouth, cracks at the corners of the mouth, a sore tongue or gums and difficulty eating. Dietary habits may influence resistance of fungi in biofilms to antifungal agents since biofilms on acrylic surfaces exposed to sugars showed higher Candida counts, phospholipase activity, and increased production of extracellular matrix substance (metabolic activity) [27].

This change usually constitutes an opportunistic infection by normally harmless micro-organisms because of local (i.

How can I treat Oral Thrush?

Sometimes they may also recommend blood tests. Oral manifestation of chronic mucocutaneous candidiasis: The doctor may turn to other antifungal drugs if thrush does not respond to fluconazole. However, if the fungus starts growing uncontrollably, it could develop into an infection in the mouth. The length and type of your therapy will depend on several factors. White patches that stick to the mouth and tongue. However, some of the symptoms can include:

Parenting Guide

Talk to your doctor, who might recommend using an antifungal ointment on your nipples while your baby is treated with the antifungal solution. These signs and symptoms have also a high probability of being a Candida-induced lesion (i. )For patients with underlying immune deficiencies such as AIDS, a course of oral treatment, using antifungal drugs, may have to be used. Esophageal candidiasis, which is much more common in people with suppressed immune systems, occurs deep in the throat, and cannot always be seen during an oral examination. In rare cases, your doctor may order a KOH test in which one of the white patches is scraped and examined. Rinse mouth with salt water. – people who are on antibiotics have a higher risk of developing oral thrush.

4 Incidence of oral candidiasis in hospitals is increasing, with hundreds more strains identified in the neonatal intensive care unit and newborn nursery.

Popular Conditions

Some babies may not feed well or are uncomfortable when sucking because their mouth feels sore, but many babies don't feel any pain or discomfort. The lesions can hurt and may bleed a little when you scrape them or brush your teeth. Gram staining is also used as Candida stains are strongly Gram positive. Pregnancy (caused by the hormonal changes that occur with pregnancy).

Deficiencies in the immune system that result from chemotherapy, radiation treatments or HIV infection can dramatically change the balance of the protective mechanisms in the body that would otherwise fight off an oral thrush infection.

In cases where you have difficulty swallowing, an endoscopy (using an endoscope, which is a long, usually flexible tube with a lens at one end and a video camera at the other) may be performed to see the extent of the infection into the digestive tract. But in people with weakened immune systems, it can spread to other parts of the body and cause potentially serious complications. J Allergy Clin Immunol. The use of inhaled corticosteroids has been shown to increase an individual’s risk for oral thrush. Breastfeeding infants may infect their mother's nipple area during breastfeeding. The vagina often has small amounts of candida naturally.

Top Thrush Related Articles

8 Sometimes a healthcare provider will take a small sample from the mouth or throat. You are receiving chemotherapy or drugs that weaken the immune system. What additional investigations might be needed? What is Oral Thrush?

Oral thrush is characterised as a white lesion in the mouth.

She may also have a severe burning pain in the nipples during and after breastfeeding. Topical antifungal agents include nystatin and clotrimazole (or other closely related agents), either of which may be applied directly to the oral lesions as a dissolving lozenge or in a liquid wash. It is a type of fungal (yeast) infection, caused most commonly by Candida albicans, but can also be caused by other non-albican species like C. But if the balance of organisms in the body is upset, yeast can multiply and produce an infection.

Adults with diabetes or other metabolic disturbance. On the other hand, some oral lesions wrongly diagnosed as oral candidiasis will be unsuccessfully treated with antifungal agents. You might have oral thrush. The natural, protective mechanisms can fail, causing the balance between “good” and “bad” microbes to shift dramatically one way or another. Oral colonization by Candida species in AIDS pediatric patients. The mouth is a common site where Candida causes infection. Clean your dentures regularly as instructed. When this balance is upset, either through an underlying condition or the use of medications, the candida is able to grow more quickly and create an infection.

Oral thrush, if left untreated, can also affect other areas of your mouth like the back of your throat, your tonsils, your gums and the roof of your mouth.

Prevention Of Oral Thrush

Similarly what determines that certain species colonize the oral cavity preferentially is not precisely determined yet. Oral thrush is caused by the overgrowth of a yeast (a type of fungus) called Candida albicans. Sometimes samples from the white lesions are taken to confirm the diagnosis. Use warm saline water as a mouth wash. Male yeast infection... A yeast infection may enter the bloodstream. It is sometimes referred to as oral candidiasis because it is caused by the group of yeasts known as Candida.

Rinse the mouth with warm saltwater. It can cause diaper rash in infants or vaginal yeast infections in women. About 45% of infants on breastmilk and almost 60% of people who wear loose or ill-fitting dentures develop oral thrush. However, when it comes to small infants or those with impaired immune systems, it can turn serious if not diagnosed and treated in a timely manner. About 35-50% of humans possess C. Smoking is a known risk factor. Thrush infection of the penis, why does sex give you a headache? – long-term use of steroid medication can increase the risk of oral thrush.


Malnutrition,[3] whether by malabsorption,[17] or poor diet, especially hematinic deficiencies (iron, vitamin B12, folic acid) can predispose to oral candidiasis,[6] by causing diminished host defense and epithelial integrity. Denture users. Next, you may have an endoscopic examination, which is where the doctor uses an endoscope (or flexible, lighted tube) to explore your esophagus, stomach and upper part of the small intestine to see how far the infection has spread. Thrush can spread to other parts of the body, including the lungs, liver and skin. In babies, oral thrush may clear spontaneously without treatment and may be prevented by sterilising all feeding equipment and mouth toys. For a breastfeeding mother, Candidal infection could result in burning, painful nipples.

This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. The amount and type of bacteria in probiotic products varies widely, so compare the labels carefully before you buy. With the drops, you use a dropper to place the liquid inside your mouth on to the affected areas four times a day. Candidal infection in the mouth is called oral thrush. The unsuccessful management of oral candidiasis can due to either incorrect diagnosis, failure to identify (or correct) the underlying predisposing factor(s), or inaccurate prescription of antifungal agents. This happens more often in people with cancer, HIV, or other conditions that weaken the immune system. Other oral thrush symptoms include: Candida overgrowth also causes diaper rash and vaginal yeast infections.

A gastroenterologist (GI doctor) performs this study.

When To Call a Doctor

Thrush is a common infection on a breastfeeding mother's nipples and in breast milk ducts. Babies birth to six months: In people with reduced immunity, thrush can be more troublesome and widespread and may require treatment with intravenous (medicine injected into the vein) or oral medication. Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children. But it can occur at any age. It is important to treat thrush early to relieve the pain and trouble swallowing, and to prevent spread of infection. 14 Diagnosis is by clinical presentation.

Considerations and Risk Factors

A sore mouth and tongue and/or difficulty swallowing. There is strong evidence that some antifungal drugs prevent oral candidiasis (thrush) caused by cancer treatment, but nystatin does not appear to work. An important measure to prevent oral thrush is to maintain good oral hygiene by: You can still breastfeed if your child has oral thrush. Candida albicans yeast, pseudohyphal, and hyphal morphogenesis differentially affects immune recognition. Adults who develop thrush include:

This is a very common condition in babies, especially in the first few months of life, when it is often passed on by the mother during childbirth; it may also occur in adults. Thrush is caused by the overgrowth of a type of fungus called Candida. However, it can be caught through direct contact with the infection, such as kissing.

Oral rinse technique can distinguish between commensal candidal carriage and candidiasis. The use of tobacco has been identified as a contributing factor in oral thrush infection. For people with lowered immunity, such as from cancer treatment or HIV/AIDS, thrush can be more serious. Treatment of oral thrush Share on Pinterest Oral thrush is caused by species of Candida fungus. However, relapse of the disease can occur if the underlying predisposing factors have not been treated. Keep a list of any symptoms you’ve experienced, including anything that may seem unrelated; your medical professional will know if they’re related.

Change your baby's diaper soon after it is wet.


That is, oral candidiasis is a mycosis (yeast/fungal infection) of Candida species on the mucous membranes of the mouth. Thrush can spread to the throat (esophagus), the vagina, or the skin. It rarely spreads to other organs of the body. Intravenous (IV) catheters and other medical equipment contaminated with Candida species can also cause invasive candidiasis.

What causes thrush?


Candida albicans is the species largely responsible for oral candidiasis which is the most common human fungal infection especially in childhood and the elderly. You might need an upper endoscopy. Clin J Oncol Nurs. Your mouth and throat normally contain millions of tiny organisms. It is not usually serious and can generally be cleared with treatment. Conversely, you may end up developing signs and symptoms completely suddenly.

Mucous Membrane Disorders

Atrophic form. This includes patients who have HIV and/or are taking immunosuppressant medication. Practice good oral hygiene.

Dry mouth – people with less than normal quantities of saliva (xerostomia) are more prone to oral thrush. The HIV/AIDs global pandemic has been the greatest factor in the increased incidence of oral candidiasis since the 1980s. These health store remedies are not as potent as prescription medication, and may not be as effective for those who have had radiation therapy or chemotherapy. The swab is then sent to the laboratory to be examined under a microscope. This medicine is usually applied several times a day by "painting" it on the inside of the mouth and tongue with a sponge applicator. They may include a swish and swallow medicine or an antifungal lozenge. One's sense of taste is altered. If oral thrush appears for no apparent reason, then talk to your pharmacist or doctor for the best advice.


Oral thrush is more likely to occur in infants and older adults due to reduced immunity. Infants can pass the oral thrush infection to the mothers during breastfeeding, and vice versa. People who smoke. Your doctor will probably prescribe antifungal drops or oral gel, which you use after each feed or meal for 10 days.

This is known as invasive or systemic candidiasis. Wash or boil all objects that the baby puts in his or her mouth, or run them through the dishwasher. Everyone who wears dentures will have candida, without necessarily suffering any ill effects. Healthy babies and children may not need treatment however—the lesions may resolve on their own.