Thrush

Thrush is a fungal infection of the oral cavity. It usually manifests as raised white patches in the mouth and throat that may have the appearance of cottage cheese. The infection is usually caused by a Candida fungus (a fungus of tbe genus Candida), of which Candida albicans is the most common. Candida is also the type of fungus that causes most diaper rash and vaginal yeast infections. Thrush may also be caused by a fungus of the genus Monila.

What Is Thrush?

Thrush is an oral fungal infection. The most common causative agent, Candida albicans, is a single-celled fungus (single-celled fungi, or yeasts, reproduce by budding) that is a natural inhabitant of the mouth. Usually, the body maintains a natural balance of microbes in the mouth. If that natural balance has been disturbed, however, Candida and other fungi may begin to grow in the warm moist environment of the mouth and throat. Other names for thrush are oral candidiasis (kan-di-DY-a-sis) and oral moniliasis (mon-i-LY-a-sis).

Thrush and the immune system: 

Thrush is common in newborns. In older children, and adults, it may be a sign of an immune system disorder. People whose immune systems have been damaged by HIV, human immuno deficiency virus, the virus that causes AIDS, for example, may develop thrush, as a properly functioning immune system is needed to maintain the natural balance of microbes in the mouth. Others at risk for thrush include individuals who are treated with antibiotics for bacterial infections and people who use steroid inhalers for asthma.

Neonatal thrush:

Infants may become infected during the birth process if their mothers have vaginal yeast infections, or they may get thrush from bottles or rubber nipples that have not been handled carefully, or from a family member or caregiver whose hands have been poorly washed. Thrush usually appears as whitish, smooth (even velvety) patches on the tongue, palate (roof of the mouth), inner cheeks, or throat. The whitish patches should not be scraped, as this will hurt the infant and leave behind an inflamed and possibly bleeding area, and infants may refuse to suck because of pain in the mouth. Candida also causes diaper rash, but the rash is reddish rather than white.

How Is Thrush Diagnosed and Treated?

A doctor can almost always diagnose thrush just by looking at the mouth and tongue. If uncertain, however, the doctor may perform a culture of one of the lesions. Thrush may be a sign of an immune system deficiency, and people with thrush or with suspected thrush should visit a doctor or dentist, who will be able to identify the yeast under a microscope if necessary, check for possible causes, and suggest ways to prevent its recurrence. For thrush in neonates and infants, treatment is often unnecessary. Doctors usually treat thrush with antifungal drugs that is either taken orally or applied directly to the affected areas. They will also recommend careful hygiene, which includes frequent hand washing, frequent diaper changes, and the use of certain mouth washes.

In some people, thrush may progress to a full systemic disease, which is generally severe. This includes persons with HIV/AIDS, persons receiving chemotherapy or immunosuppressant drugs, or persons with some other immune system disorder. The treatment for this type of often-severe candidiasis is intravenous antifungal medication, which is administered in a hospital setting.

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