This article discusses fungal infection known as oral candidiasis. It is the most common opportunistic infection of the oral cavity.
Oral candidiasis is the most common opportunistic infection of the oral cavity, which is observed mostly in patients who have low immunity like HIV, diabetic patients, and those who belong to older age group wearing dentures. Though there are several Candida species, Candida albicans is most commonly associated with it.
It presents as curd-like, atrophic, speckled, and hyperplastic lesion. Accordingly, there are several types of candidiasis. These are:
There are several causes associated with it, which are:
Clinical examinations followed by investigations are usually done to diagnose this condition. Usually, the scrapping of lesion exposes the erythematous red surface beneath which distinguishes it from leukoplakia. The culture of the lesion shows the presence of fungi. Other investigations like complete blood count, glucose levels, hemoglobin estimation, and various tests for antibodies reveal underlying diseases like diabetes, anemia, leukemia, and autoimmune disorders.
The management requires multipronged strategy depending upon the cause. The various strategies are:
Several preventive measures can be taken to prevent the infection. These are:
Remember: "Prevention is always better than cure."
Burning sensation of the mouth, pain in the mouth during eating, creamy white patches on the gums, inner cheeks, tongue, palate, and throat that can be rubbed off to reveal red spots underneath, mouth sore, redness, reduced or no taste sensation, and cracked corners of the mouth are the presenting features of oral candidal infection.
Diagnostic investigations for oral candidiasis include a visual inspection of the creamy white curd-like intraoral patches involving the gums, palate, cheeks, tongue, bacterial cultures, and microscopic examination of the smeared scrapped off white plaques. A potassium hydroxide preparation reveals spores and non-septate mycelium. Also, the intraepithelial pseudomycelia of Candida albicans can be identified in the biopsy.
There are creamy curd-like white patches or plaques over the gingiva, roof of the mouth (palate), tongue, and inner cheek in oral thrush. These white plaques are easily scraped off or removed upon which it reveals an erythematous area, and gingival redness indicates oral thrush.
Oral thrush causes the burning sensation of the mouth, bad taste, discomfort with spicy food, mouth soreness, and painful cracks at the corners of the mouth.
Oral thrush does not spread from one person to another. It occurs when there is poor body immunity, poor oral hygiene, dry mouth, and prolonged steroid or antibiotic therapy.
The causative organism of oral thrush, Candida species, is present in everyone’s oral cavity and skin in normal conditions. Upon favorable conditions, they grow and multiply to cause oral thrush.
Oral thrush occurs due to a weak immune system, excessive use of inhaled or systemic steroids, diabetes, smoking, long-term antibiotic therapy altering the oral microbial environment, altered immunity in people with cancer, HIV, etc., and poor oral hygiene.
Yeast or fungal (Candida species) infection of the oral cavity leads to oral thrush. In conditions of immune deficiency like cancer chemo or radiotherapy, HIV, long-term steroids, etc., poor oral hygiene, smoking, and overzealous antibiotic therapy make a person susceptible to Candida infection. They alter the normal oral ecology and create conditions favorable for Candidal growth.
- Lichen Planus.
- Chemical injury in the oral cavity.
- Gangrenous stomatitis.
Initial removal of the underlying cause by maintaining clean dentures, removing them at night, maintaining good oral hygiene, withdrawing or changing antibiotics, discontinuing smoking, etc., must be done, followed by topical and systemic antifungal medications for seven days. Symptoms tend to disappear within five days. Chlorhexidine mouthwash can also be used regularly.
- Topical Antifungals:
Oral Nystatin suspension.
Amphotericin B rinse.
- Systemic Antifungals:
Itraconazole (contraindicated in people taking Cisapride, Triazolam, Astemizole, and Midazolam).
Candidal infections in babies regress most of the time within a week or two on their own, where careful monitoring of the baby is advised. Otherwise, physicians recommend topical antifungal drops or creams to treat oral thrush in toddlers. It is advised to be applied all over the tongue and mouth with a sponge applicator.
Last reviewed at:
02 Jun 2019 - 2 min read
Query: Hello doctor, I have a sore throat and trouble swallowing. I had Candida albicans in the throat and saw an ENT two days ago. He said it was almost gone but I have an inflamed papilla. Could that be the reason? I have trouble eating and drinking now. Read Full »
Query: Hello doctor, I have been diagnosed with candida albicans in the throat through an endoscopy. I had a sore throat in the beginning and was misdiagnosed and given antibiotics which made things worse. I have been on Nystatin twice a day 5 ml each and Betadine twice a day for two weeks now. I have als... Read Full »
Article Overview: This article discusses about the clinical presentation and management of candidiasis. Read Article
An infection caused by the yeast (fungus), Candida albicans is known as candidiasis. This infection is usually confined to the skin, nail, mucus membranes and gastrointestinal tract. But, it can also infect internal organs and cause systemic disease. Candida albicans is an oval yeast, which divides... Read Article
Most Popular Articles
Do you have a question on Topical Antifungal or Oral Candidiasis?Ask a Doctor Online
The terms and conditions (hereinafter collectively referred to as, the "Terms of Service") set out herein shall be a legally binding Agreement between Orane Healthcare India Pvt. Ltd., a company incorporated under the Companies Act, 1956, having its registered office at No.174, Rangasamy Goundenpudur, Chinniyampalayam (PO), Coimbatore – 641062, Tamil Nadu, India (hereinafter interchangeably referred to as, "We" or "Us" or "Our" or the "Company" or "iCliniq"), and you (hereinafter referred to as, "You" or "Your"), as the Registered Doctor (defined below) or Registered Alternative Medicine Practitioner (defined below) or Wellness Professional (defined below) or User / Registered User (defined below) on the Platform (defined below) and/or the services offered through the Platform. The Platform is developed and maintained by the Company.
The Terms of Service shall govern your use of the Platform and its services offered through the Platform, therefore, please read and understand the Terms of Service before you access the services, view, download, install or Register with or use the Platform. If you are not agreeable to this Terms of Service, then you shall not access, view, download or install the Platform, or use the Platform or the services offered through the Platform, and if you are accessing, installing, using, or viewing the Platform, then you shall delete the account and desist from such accessing, using, installing or viewing the Platform.
PART – A
PART - B
PART - C
*Please check to continue futher