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Thrush - children and adults

Candidiasis - oral; Oral thrush; Fungal infection - mouth; Candida - oral

 

Thrush is a yeast infection of the tongue and lining of the mouth.

Causes

 

Certain germs normally live in our bodies. This includes bacteria and fungi. While most germs are harmless, some can cause infection under certain conditions.

Thrush occurs in children and adults when conditions permit too much growth of a fungus called candida in your mouth. A small amount of this fungus normally lives in your mouth. It is most often kept in check by your immune system and other germs that also live in your mouth.

When your immune system is weak or when normal bacteria die, too much of the fungus can grow.

You are more likely to get thrush if:

  • You are in poor health.
  • You are very old. Young babies are also more likely to develop thrush.
  • You have HIV or AIDS .
  • You are receiving chemotherapy or drugs that weaken the immune system.
  • You are taking steroid medicine, including some inhalers for asthma and chronic obstructive pulmonary disease (COPD).
  • You have diabetes mellitus and your blood sugar is high. When your blood sugar is high, some of the extra sugar is found in your saliva and acts as food for candida.
  • You take antibiotics. Antibiotics kill some of the healthy bacteria that keep candida from growing too much.
  • Your dentures do not fit well.

Candida can also cause yeast infections in the vagina.

Thrush in newborns is somewhat common and easy to treat.

 

Symptoms

 

Symptoms of thrush include:

  • White, velvety sores in the mouth and on the tongue
  • Some bleeding when you brush your teeth or scrape the sores
  • Pain when swallowing

 

Exams and Tests

 

Your health care provider or dentist can usually diagnose thrush by looking at your mouth and tongue. The sores are easy to recognize.

To confirm you have thrush, your provider may:

  • Take a sample of a mouth sore by gently scraping it
  • Examine mouth scrapings under a microscope

In severe cases, thrush can grow in your esophagus as well. The esophagus is the tube that connects your mouth to your stomach. If this occurs, your provider may:

  • Take a throat culture to see what germs are causing your thrush
  • Examine your esophagus and stomach with a flexible, lighted scope with a camera on the end

 

Treatment

 

If you get mild thrush after taking antibiotics, eat yogurt or take over-the-counter acidophilus pills. This may help restore a healthy balance of germs in your mouth.

For a more severe case of thrush, your doctor may prescribe:

  • Antifungal mouthwash (nystatin).
  • Lozenges (clotrimazole).
  • Antifungal medicines taken as a pill or syrup, these medicines include fluconazole (Diflucan) or itraconazole (Sporanox).

 

Outlook (Prognosis)

 

Oral thrush can be cured. However, if your immune system is weak, thrush may come back or cause more serious problems.

 

Possible Complications

 

If your immune system is weakened, candida can spread throughout your body, causing a serious infection.

This infection might affect your:

  • Brain ( meningitis )
  • Esophagus (esophagitis)
  • Eyes ( endophthalmitis )
  • Heart ( endocarditis )
  • Joints ( arthritis )

 

When to Contact a Medical Professional

 

Call your provider if:

  • You have thrush-like sores.
  • You have pain or difficulty swallowing.
  • You have symptoms of thrush and you are HIV positive, receiving chemotherapy, or you take medicines to suppress your immune system.

 

Prevention

 

If you get thrush often, your provider may recommend taking antifungal medicine on a regular basis to keep thrush from coming back.

If you have diabetes mellitus, you can help prevent thrush by keeping good control of your blood sugar levels.

 

 

Open References

References

Edwards JE Jr. Candida species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 258.

Kauffman CA. Candidiasis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 338.

 
  • Candida, fluorescent stain

    Candida, fluorescent stain - illustration

    This microscopic film shows a fluorescent stain of Candida. Candida is a yeast (fungus) that causes mild disease, but in immunocompromised individuals it may cause life-threatening illness. (Image courtesy of the Centers for Disease Control and Prevention.)

    Candida, fluorescent stain

    illustration

  • Mouth anatomy

    Mouth anatomy - illustration

    The mouth is the origination of the digestive tract. The teeth and salivary glands aid in breaking down food for digestion. The tonsils aid against infections.

    Mouth anatomy

    illustration

    • Candida, fluorescent stain

      Candida, fluorescent stain - illustration

      This microscopic film shows a fluorescent stain of Candida. Candida is a yeast (fungus) that causes mild disease, but in immunocompromised individuals it may cause life-threatening illness. (Image courtesy of the Centers for Disease Control and Prevention.)

      Candida, fluorescent stain

      illustration

    • Mouth anatomy

      Mouth anatomy - illustration

      The mouth is the origination of the digestive tract. The teeth and salivary glands aid in breaking down food for digestion. The tonsils aid against infections.

      Mouth anatomy

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Thrush - children and adults

           
             

            Review Date: 9/10/2015

            Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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