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Thrush

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Candidiasis - oral; Oral thrush

Treatment:

For thrush in infants, treatment is often NOT necessary. It generally resolves on its own within two weeks.

There are two goals when treating oral thrush in adults. The first is to improve your immune system's ability to function. For example, in diabetics, good control of diabetes may be enough to clear the infection without other treatment.

The second is to directly treat the infection. For this purpose, your doctor may prescribe an antifungal mouthwash or lozenges to suck on. These are usually used for 5-10 days. If they don't work, other medication may be prescribed.

If the infection has spread throughout your body or you have HIV/AIDS, stronger medications may be used, such as ketoconazole (Nizoral) or fluconazole (Diflucan).

Expectations (prognosis):

Thrush in infants may be painful, but is rarely serious. Because of discomfort, it can interfere with eating. If it does not resolve on its own within 2 weeks, call your pediatrician.

In adults, oral candidiasis can be cured. However, the long-term outlook is dependent on your immune status and the cause of the immune deficit.

Complications:

The candida organism can spread throughout your body, causing infection in your esophagus ( esophagitis ), brain ( meningitis ), heart ( endocarditis ), joints ( arthritis ), or eyes ( endophthalmitis ).

Calling your health care provider:

Call your doctor if:

• Your infant has had lesions in the mouth consistent with thrush for at least 2 weeks.
• Your infant is eating poorly due to the lesions.
• You are a teen or adult with lesions that are consistent with thrush.
• You have pain or difficulty swallowing.
• You have symptoms of thrush and you are HIV positive, receiving chemotherapy, or take medications to suppress your immune system.

References:

Goldman L, Ausiello D, eds. Cecil Textbook of Medicine . 22 ^nd Ed. Philadelphia, PA: Saunders; 2004.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5 ^th Ed. St. Louis, MO: Mosby; 2002.

Mandell GL, Bennett JE, Dolin R, eds. Principles of Infectious Diseases . 5 ^th Ed. New York, NY: Churchill Livingstone, 2000.

• Review Date: 10/27/2005
• Reviewed By: Angelique Green, MD, Assistant Clinical Professor, UCSF School of Medicine, Director of Urgent Care Center, San Francisco General Hospital, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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