How to recognize thrush symptoms oropharyngeal candidiasis

Candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Candida normally lives on the skin and inside the body, in places such as the mouth, throat, gut, and vagina, without causing any problems. 1 Sometimes, Candida can multiply and cause an infection if the environment inside the mouth, throat, or esophagus changes in a way that encourages fungal growth.

Candidiasis in the mouth and throat is also called thrush or oropharyngeal candidiasis. Candidiasis in the esophagus (the tube that connects the throat to the stomach) is called esophageal candidiasis or Candida esophagitis. Esophageal candidiasis is one of the most common infections in people living with HIV/AIDS. 2

Symptoms

How to recognize thrush symptoms oropharyngeal candidiasis

Candidiasis in the mouth and throat can have many different symptoms, including:

  • White patches on the inner cheeks, tongue, roof of the mouth, and throat (photo showing candidiasis in the mouth)
  • Redness or soreness
  • Cotton-like feeling in the mouth
  • Loss of taste
  • Pain while eating or swallowing
  • Cracking and redness at the corners of the mouth

Symptoms of candidiasis in the esophagus usually include pain when swallowing and difficulty swallowing.

Contact your healthcare provider if you have symptoms that you think are related to candidiasis in the mouth, throat, or esophagus.

Risk and Prevention

Who gets candidiasis in the mouth or throat?

Candidiasis in the mouth, throat, or esophagus is uncommon in healthy adults. People who are at higher risk for getting candidiasis in the mouth and throat include babies, especially those younger than 1 month of age, and people with at least one of these factors: 3-7

  • Wear dentures
  • Have diabetes
  • Have cancer
  • Have HIV/AIDS
  • Take antibiotics or corticosteroids, including inhaled corticosteroids for conditions like asthma
  • Take medications that cause dry mouth or have medical conditions that cause dry mouth
  • Smoke

Most people who get candidiasis in the esophagus have weakened immune systems, meaning that their bodies don’t fight infections well. This includes people living with HIV/AIDS and people who have blood cancers such as leukemia and lymphoma. People who get candidiasis in the esophagus often also have candidiasis in the mouth and throat.

How can I prevent candidiasis in the mouth or throat?

Ways to help prevent candidiasis in the mouth and throat include:

  • Maintain good oral health
  • Rinse your mouth or brush your teeth after using inhaled corticosteroids

Sources

Candida normally lives in the mouth, throat, and the rest of the digestive tract without causing any problems. Sometimes, Candida can multiply and cause an infection if the environment inside the mouth, throat, or esophagus changes in a way that encourages its growth.

This can happen when:

  • a person’s immune system becomes weakened,
  • if antibiotics affect the natural balance of microbes in the body,
  • or for a variety of other reasons in other groups of people.

Diagnosis and Testing

Healthcare providers can usually diagnose candidiasis in the mouth or throat simply by looking inside. 8 Sometimes a healthcare provider will take a small sample from the mouth or throat. The sample is sent to a laboratory for testing, usually to be examined under a microscope.

Healthcare providers usually diagnose candidiasis in the esophagus by doing an endoscopy. An endoscopy is a procedure to examine the digestive tract using a tube with a light and a camera. A healthcare provider might prescribe antifungal medicine without doing an endoscopy to see if the patient’s symptoms get better.

Treatment

Candidiasis in the mouth, throat, or esophagus is usually treated with antifungal medicine. 6 The treatment for mild to moderate infections in the mouth or throat is usually an antifungal medicine applied to the inside of the mouth for 7 to 14 days. These medications include clotrimazole, miconazole, or nystatin. For severe infections, the most common treatment is fluconazole (an antifungal medication) taken by mouth or through a vein. If patient does not get better after taking fluconazole, healthcare providers may prescribe a different antifungal. The treatment for candidiasis in the esophagus is usually fluconazole. Other types of prescription antifungal medicines can also be used for people who can’t take fluconazole or who don’t get better after taking fluconazole.

If you are a healthcare provider, click here to see the Infectious Diseases Society of America’s Clinical Practice Guidelines for the Management of CandidiasisExternal external icon .

Statistics

The exact number of cases of candidiasis in the mouth, throat, and esophagus in the United States is difficult to determine. This is because there is no national surveillance for these infections. The risk of these infections varies based on the presence of certain underlying medical conditions. For example, candidiasis in the mouth, throat, or esophagus is uncommon in healthy adults. However, they are some of the most common infections in people living with HIV/AIDS. 2 In one study, about one-third of patients with advanced HIV infection had candidiasis in the mouth and throat. 9

Candida infection that involves the mouth, throat and/or oesophagus is referred to as oropharyngeal or oesophageal candidiasis or thrush.

Causes of oral thrush

Oral thrush occurs when certain medications (like antibiotics or corticosteroids) are taken or the immune system is weakened due to illness. These medications as well as certain health conditions disturb the natural balance of ‘healthy bacteria’ in the body which leads to the multiplication of Candida 14 . When this growth remains unchecked, an infection (candidiasis) occurs and leads to the development of various symptoms associated with oral thrush.

Oral thrush symptoms

What does oral thrush look like?

Oral thrush is generally easily identified by a thick, white coating on the tongue and white patches / plaques on the insides of the cheeks and throat. As one descends down the throat and into the gastrointestinal tract (generally only visible when using an endoscope), the patches continue, as is evident in the images below.

From left to right: Oral candidiasis apparent on the tongue, back of the throat, and the oesophagus.

Other symptoms may include:

  • Soreness or redness in the areas affected
  • Difficulty in swallowing
  • Painful sores on the sides of the mouth that result in the corners cracking due to the build-up of microorganisms (this is known as angular cheilitis) – these sores often cause a burning sensation in the affected area
  • Nausea
  • Vomiting
  • Weight loss

If you are experiencing any of these symptoms, it is advised that you see your doctor for treatment. The earlier treatment begins, the better the outlook.

Who is at risk of developing oral candidiasis?

Babies, toddlers, the elderly and people who suffer from a weakened immune system are most at risk of experiencing oral candidiasis (oral thrush). These infections are uncommon in healthy adults.

Other factors that are associated with the development of oesophageal and oral candidiasis, these include:

  • Broad-spectrum antibiotic use – these are antibiotics that work against a large range of bacteria, including the healthy bacteria that keep Candida growth in check.
  • Corticosteroid use (including inhaled corticosteroids for conditions like asthma) that is poorly managed
  • Poorly fitted dentures
  • Cancer treatments – These include radiation and chemotherapy as these treatment methods have an adverse impact on the immune system
  • HIV/AIDS infection
  • Organ transplantation

Can oral candidiasis be prevented?

The development of oral thrush depends on the strength of one’s immune system, this is why babies, the elderly and the immunocompromised are often most affected. Practising good oral hygiene helps to prevent oral thrush from occurring.

Some studies show that mouthwash containing chlorhexidine (CHX) can aid in preventing oral thrush 15,16 . Those who use an inhaler for the administration of corticosteroids (asthma medication), can benefit from washing their mouth out with mouthwash or even water after using their inhaler.

Diagnosis of oral thrush

An oral thrush infection will be diagnosed based on visible symptoms. The treating doctor may also scrape off some of the affected area in order for it to be examined. This procedure is quick and painless and allows for the sample of the infected area to be analysed and tested for the presence of fungal infections.

A culture test using a cotton swab can also be performed, however, due to the fact that Candida organisms occur naturally in the mouth, if the culture test is positive, this is not enough evidence to make an accurate diagnosis of infection (candidiasis).

Treatment of oral thrush and outcome

Antifungal medication is typically prescribed for oral thrush 16 . The duration and type of treatment will be dependent on the infection’s severity, as well as various factors regarding the sufferer such as their age and immune system status.

Topical treatments including nystatin suspension and clotrimazole troches are often used in the treatment of oral thrush. Antifungal medication that is systemic (i.e. drugs that act through the entire body), such as itraconazole or fluconazole, are sometimes necessary when oropharyngeal infections do not respond to other medications.

Itraconazole or intravenous fluconazole are common treatments for Candida esophagitis. In more severe cases of oesophageal candidiasis that do not respond to antifungal medications, a treatment containing amphotericin B may be used. This form of treatment will injure the membranes of the fungal cell, making it more permeable for other medications to treat and eliminate.

References

14. Agrawal A, Singh A, Verma R, Murari A. Oral candidiasis: An overview. Journal of Oral and Maxillofacial Pathology . 2014;18(4):81. doi:10.4103/0973-029x.141325

15. Scheibler E, Garcia M, Medina da Silva R, Figueiredo M, Salum F, Cherubini K. Use of nystatin and chlorhexidine in oral medicine: Properties, indications and pitfalls with focus on geriatric patients. Gerodontology. 2017;34(3):291-298. doi:10.1111/ger.12278

16. Oral thrush: Prevention during cancer treatment. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK367590/. Published 2006. Accessed May 22, 2019.

17. Patil S, Rao R, Majumdar B, Anil S. Clinical Appearance of Oral Candida Infection and Therapeutic Strategies. Front Microbiol. 2015;6.doi:10.3389/fmicb.2015.01391

Mouth thrush is a painful oral infection caused by Candida albicans, a type of fungus that also causes yeast infections. It most often occurs in young children and babies, older adults, and those suffering from HIV infection or cancer. It’s characterized by raised white lesions on the tongue and inner cheeks that can be quite painful and even bleed. In rare cases, the infection may spread down the esophagus leading to a high fever and other complications.

Suck on a sugar-free popsicle. A cold popsicle can soothe the discomfort of mouth thrush for up to several minutes. The cooling sensation numbs the pain. An affordable tip: pour some of your favorite sugar-free juice (dilute with water if it’s too thick) into an ice cube tray then suck on the ice cubes instead of a popsicle. Also, try just sucking on a regular ice cube for the same numbing effect without the flavor. Sugar will feed the yeast in the infection, but sugar-free popsicles and juice are safe.

Take over-the-counter pain medications. Pain medicine like Advil or Tylenol can help ease the pain of mouth thrush for up to several hours. If the pain is extremely severe, ask your doctor for a prescription for a more potent pain medication, such as Vicodin.

Eat small amounts of sugar-free fruit sorbet throughout the day. Like the popsicle or ice cubes, fruit sorbet also offers a pleasant cooling sensation to dull the pain of mouth thrush.

Steep a calendula or echinacea tea bag in hot water for about a minute. Remove from the water and allow to cool. Place the tea bag in your mouth where the pain from the mouth thrush is at its worst. Calendula and echinacea are two herbs known for reducing inflammation and soothing soreness in the mouth.

Use baking soda to ease the pain of mouth thrush. Baking soda is known for its pain-soothing qualities. Mix a teaspoon of baking soda with lukewarm water. Slosh the mixture in your mouth for at least 30 seconds then spit out. Sloshing your mouth with salt-water works well also.

Avoid spicy and acidic foods (like citrus fruits) that will only exacerbate the pain.

Avoid eating too many dairy products; they also feed the yeast in the infection.

Candidiasis (kan-di-DYE-uh-sis) is a fungal infection caused by an overgrowth of the common yeast candida, which is found on everyone’s body.

More to Know

Candidiasis in newborns usually appears as diaper rash. But babies also can develop it in the mouth or throat (called oral thrush, or oropharyngeal candidiasis). This very common infection causes cracks in the corners of the mouth and white patches on the tongue, palate, lips, and insides of the cheeks. Often, these babies picked up the fungus during breastfeeding or from their mother’s vagina during delivery.

Candidiasis in the vagina (vulvovaginal candidiasis) is commonly called a yeast infection. Vaginal yeast infections can cause pain, itching, redness, a thick white vaginal discharge, pain during urination, and sometimes whitish patches on the skin of the vaginal area. Yeast infections can happen to any girl, and are not considered sexually transmitted infections.

Keep in Mind

Thrush in babies is treated with liquid antifungal medicine. Thorough cleaning of all bottle-feeding supplies can help prevent thrush in formula-fed infants. A breastfeeding mom whose nipples are red and sore might be passing the infection back and forth with her baby; in that case, a doctor might recommend antifungal medications.

In most cases, vaginal yeast infections can be prevented by keeping the vaginal area clean and dry. Doctors typically treat them with prescription medication taken by mouth or a vaginal cream, tablet, or suppository; these will clear up the symptoms in a few days and the infection within a week.

All A to Z dictionary entries are regularly reviewed by KidsHealth medical experts.

How to recognize thrush symptoms oropharyngeal candidiasis

Candida is a type of yeast. Small amounts of this yeast live harmlessly on and inside the body. However, certain factors can cause the yeast to multiply out of control, resulting in a Candida infection.

This article describes what Candida is and outlines the different types of Candida infection, or overgrowth, along with their associated symptoms.

Then, we explore the many treatment options.

Candida is a type of yeast that lives on and inside the human body. Small amounts typically exist on the skin, and inside the mouth, vagina, and gut.

Small amounts of Candida are harmless and cause no symptoms. However, certain factors can cause this fungus to multiply out of control, resulting in a Candida infection, which is called “candidiasis.”

Under normal conditions, Candida is harmless. The bacteria living on and in the body combined with the efforts of the immune system help keep Candida populations under control.

However, a person may develop candidiasis if their bacteria are suppressed or their immune system is weakened. Some common causes of candidiasis include:

Other possible causes of candidiasis include :

Candidiasis does not typically pass from person to person, though this is possible. Vaginal candidiasis may pass to a partner during sex, for example.

Also, if a Candida infection enters the bloodstream, it can spread to various other parts of the body, such as the eyes, kidneys, and other organs.

Symptoms of candidiasis vary based on the location of the infection. Below, learn more about the possible locations of a Candida infection and the associated symptoms.

Candidiasis of the mouth or throat

Other names for candidiasis of the mouth or throat are oral thrush and “oropharyngeal candidiasis.” It can cause the following symptoms:

  • white patches on the:
    • palate
    • tongue
    • inner cheeks
    • gums

    Candidiasis of the skin

    “Cutaneous candidiasis” is the medical term for this skin infection. Because Candida thrives in warm, moist environments, cutaneous candidiasis often develops in the folds of the skin.

    Cutaneous candidiasis can cause the following symptoms:

    • inflamed skin that may crack or peel, in people with darker skin
    • red, circular patches surrounded by red pustules, in people with lighter skin
    • areas of itchy skin
    • hair loss, if the infection occurs on the scalp

    Candidiasis of the nails

    An overgrowth of Candida around the nail beds can cause candidiasis of the nails. Symptoms may include:

    Learn more about candidiasis of the skin and nails here.

    Candidiasis of the vagina

    A Candida infection on or inside the vagina is called a vaginal yeast infection or “vaginal candidiasis.” These infections are common.

    Some possible symptoms of vaginal candidiasis include:

    Candidiasis of the penis

    A Candida infection on the penis is called “penile candidiasis.” The condition is less common than vaginal candidiasis. A person may develop penile candidiasis after sexual intercourse with someone who has vaginal candidiasis.

    Penile candidiasis can cause painful swelling at the tip of the penis. Other possible symptoms include:

    • irritation and burning around the head of the penis and under the foreskin
    • difficulty pulling back the foreskin
    • a thick, white substance building up around the foreskin
    • shiny white or red patches on the penis
    • an unpleasant odor

    Candidiasis of the blood

    “Candidemia” is the medical term for a Candida infection of the bloodstream.

    The symptoms vary, according to the location of the infection in the body. However, it can cause generalized symptoms, such as a fever and chills.

    The condition may also cause septic shock, with the following symptoms:

    When diagnosing candidiasis, a doctor typically asks about the person’s symptoms and reviews their medical history.

    The doctor may be able to diagnose candidiasis on the skin based on a visual examination alone.

    Or, a doctor may take a scraping from the area and examine the cells under a microscope. They may prefer to do this for suspected candidiasis of the skin, mouth, or nails.

    If the doctor suspects that the yeast has spread to the blood, they may order lab work to check for antibodies that the immune system produces in response to a Candida infection.

    Doctors typically recommend over-the-counter or prescription antifungal medications to treat candidiasis. These medications work by either killing the fungus or preventing it from growing.

    The best type of antifungal medication depends on the location of the infection. A person might use antifungal:

    • creams, gels, or ointments
    • capsules, tablets, or liquids
    • pessaries
    • powders
    • injections

    The doctor may also recommend stopping any medications that may cause an overgrowth of Candida. This might involve stopping the use of antibiotics or corticosteroids. However, do not do this unless the doctor recommends it.

    A person should contact a doctor if they experience any of the following:

    • a persistent or recurrent Candida infection
    • a skin rash that does not go away with topical antifungal treatment
    • more than two episodes of vaginal or penile candidiasis in 6 months
    • symptoms of a Candida infection in the blood during or following any other type of Candida infection

    Also, anyone with a weakened immune system who develops this type of infection should contact a doctor, who may prescribe medications to reduce the risk of complications.

    It is not always possible to prevent candidiasis. To reduce the risk, try:

    • keeping the skin clean and dry
    • only using antibiotics when a doctor has prescribed them
    • maintaining a healthful diet
    • keeping blood sugar levels under control, for people with diabetes

    Candida is a type of yeast that normally lives on or inside various parts of the body.

    Ordinarily, bacteria and the immune system work together to keep Candida numbers under control — but certain factors can cause the yeast to multiply uncontrollably, resulting in a Candida infection, which is called candidiasis.

    Among the factors that can increase the risk of candidiasis include the overuse of antibiotics and certain health issues and treatments that weaken the immune system.

    The symptoms of candidiasis depend on the location of the infection. A person may be able to treat the infection at home, but if Candida infections are persistent or recurrent, contact a doctor.

    Oral candidiasis is a fungal disease. The most noticeable candidiasis of the tongue, since the rest of the mucous membrane is not visible so well. This disease in the mouth can be found in any person and its manifestations have various forms.

    How to recognize thrush symptoms oropharyngeal candidiasis

    What does candidiasis look like?

    The symptoms of the disease are very diverse. The reasons provoking the appearance are just as numerous. Like all diseases, oral candidiasis (picture 2) has both an acute form and a chronic one. The forms of thrush can manifest themselves independently, move one into another.

    How to recognize thrush symptoms oropharyngeal candidiasis

    Oral candidiasis causes bleeding of the gums and is difficult to identify at first. Only after the appearance of the raid are all doubts discarded. However, plaque does not always appear abundantly. The first symptoms: pain and burning of the palate, itching of the gums, can appear not only during eating – neglected oral candidiasis manifests them when the facial muscles move.

    Most often, candidiasis of the oral cavity (photo below) still envelops the entire cavity with a cheesy bloom. Easily removable in the beginning, it leaves bleeding ulcers in a neglected form. Candidiasis can instantly manifest itself with a weakened immune system. Quite often, thrush in girls appears after diet abuse. The weakened organism attacks the disease.

    How to recognize thrush symptoms oropharyngeal candidiasis

    Candidiasis of the tongue pictures

    The atrophic process that causes candidiasis of the tongue (picture 3) is accompanied by burning, dryness. The resulting pain makes the mobility of the tongue limited. The tongue in the mouth turns dark red. At the same time, the papillae are smoothed out and become shiny. There is puffiness, the presence of films.

    Candidiasis on the tongue can manifest itself as white plaques of various sizes. Removing them is hard enough. The fungus in the mouth covers the back of the tongue with nodules. Quite often, atrophic candidiasis of the oropharynx locates plaque only deep in the folds. Thrush in the mouth of a child under one year old looks quite different. At the same time, there is an abundant bloom of curd consistency.

    How to recognize thrush symptoms oropharyngeal candidiasis

    Throat candidiasis pictures

    Unnoticed in the body, the fungus causes candidiasis of the throat (picture 4). This is the main breeding ground. Also, candidiasis of the pharynx can occur from the penetration of the fungus with food. The disease covers the mucous membrane with translucent red and white spots. Ulcers and blisters are often formed. Laryngeal candidiasis causes severe discomfort and pain. The temperature often rises, coughing, perspiration appear. And tonsil candidiasis (image below) when eating can cause a gag reflex.

    Over time, oropharyngeal candidiasis covers the mucous membrane with a grayish coating, under which there are entire foci of ulcers. An unpleasant increase in symptoms causes the manifestation of thrush in men with bad habits. Alcohol and tobacco burns the inflamed areas, increasing the burning sensation and pain. Oral candidiasis causes loss of appetite, thereby contributing to the weakening of the body.

    How to recognize thrush symptoms oropharyngeal candidiasis

    Oropharyngeal candidiasis pictures

    Inflammation of the entire oral mucosa is called oropharyngeal candidiasis (picture 5). The disease begins with a worsening of the condition. It is often confused with ordinary SARS. The illness in infants is always accompanied by fever, lethargy. Oropharyngeal candidiasis forms a plaque on the inflamed mucosa. Over time, the plaque thickens, forming films. Thrush of the oral mucosa, covering the inner mucosa, often passes to the outer membrane.

    Candidiasis on the lips (photo below) forms the so-called seizures. They often arise from the bad habit of holding matches, pens in the mouth. In newborns, the disease can be provoked by an ordinary pacifier, which mothers love to lick before giving to the child. Acute candidiasis in the mouth of a child stains the cavity in a raspberry color. Tickling, coughing, pain, burning appear. Often, candidiasis in women is provoked by dentures. Food trapped under them creates ideal conditions for the growth of fungi.

    How to recognize thrush symptoms oropharyngeal candidiasis

    Generalized candidiasis pictures

    In recent years, generalized candidiasis (picture 6) has become widespread. In this case, internal organs are infected. The cause is often antibiotics, which people use in large quantities. The disease is especially often observed in children, since antibiotics easily inhibit gram-negative cocci in a fragile body. Generalized candidiasis affects the mucous membranes of the kidneys, bronchi, heart muscles, brain tissue, liver. There are no particular symptoms.

    The disease is determined only when it reaches its peak. This candidiasis in children (picture below) can be suspected only by minor signs accompanying organ damage. Alopecia causes candidiasis in men on the head and the appearance of spots on the body. Keratinization appears on the nails. The infection can develop in the body for years without attracting attention. The clinical picture often appears after complete damage to the body.

    Pamela Assid, DNP, RN, is a board-certified nursing specialist with over 25 years of expertise in emergency, pediatric, and leadership roles.

    Casey Gallagher, MD, is board-certified in dermatology and works as a practicing dermatologist and clinical professor.

    Oral thrush, also known as oral candidiasis, is when Candida, the type of fungus that causes yeast infections, overgrows in the mouth. Even though it’s easy to think of oral thrush as an infection affecting only the inside of your mouth, it can actually also affect your lips.

    Candida normally lives on the skin and inside the body, in places such as the mouth, throat, gut, and vagina, without causing any problems. However, Candida can multiply and cause an infection if the environment inside the mouth or throat changes in a way that encourages fungal growth.

    Anyone can have oral thrush, but people with a weakened immune system are more susceptible to the infection. A small clinical trial found that one-third of 122 patients with advanced AIDS had oral candidiasis.

    How to recognize thrush symptoms oropharyngeal candidiasis

    Zarina Lukash / Getty Images

    Symptoms of Thrush on the Lips

    Common areas affected by oral thrush include the lips, tongue, throat, roof of the mouth, and the lining of the cheeks and back of the lips, which is known as the buccal area.

    Symptoms of oral thrush include the following:

    • White patches on the tongue, throat, and lips
    • Redness or soreness anywhere in the mouth, including the corners of the mouth
    • Cracks and tiny cuts at the corner of the mouth
    • Cotton-like feeling in the mouth
    • Loss of taste
    • Pain with eating and swallowing

    Thrush can also affect the esophagus—the tube that connects the throat to the stomach. Candidiasis in this area is called esophageal candidiasis or Candida esophagitis. It is one of the most common infections in people living with HIV/AIDS.

    Conditions With Similar Symptoms

    A few conditions can present similarly to thrush:

      : This is an oral condition where cells in the mouth grow excessively and appear as white patches. This condition often occurs in people who use tobacco products and can be a precursor to oral cancer. It should be evaluated by a healthcare provider, including a dentist.
    • Oral lichens planus: People with this condition have raised white lines on the tongue. It is not considered to be life threatening and may not cause any long-term complications. : Symptoms of this condition include a map-like pattern of reddish spots that may have a white border on the tongue. This condition is also generally considered harmless.

    Since these conditions can present similarly to thrush, it’s important to see your healthcare provider if you have thrush symptoms to get an accurate diagnosis.

    Causes of Lip Fungus

    While yeast is inside all of us, people who have a weakened immune system are more susceptible to thrush. Different diseases that can weaken our immune system include diabetes, cancer, and HIV/AIDS.

    Other risk factors that can weaken the immune system and increase someone’s likelihood of having thrush include:

    • Being less than 1 month old
    • Smoking
    • Wearing dentures
    • Using broad-spectrum antibiotics
    • Using oral or inhaled corticosteroids for conditions like asthma
    • Using long-term immunosuppressive medications
    • Taking medications that can dry out the mouth, or having chronic dry mouth
    • Frequent licking of the lips or thumb-sucking

    Treatment

    For mild cases of thrush, such as with infants, oral thrush often resolves on its own without any treatment. Depending on the age of the patient, as well as their baseline health status, eating lactobacillus foods, such as a yogurt, may help.

    For minor to moderate thrush infections, your healthcare provider may prescribe an antifungal medication such as Bio-Statin (nystatin). This medication comes in different forms, such as lozenges, liquid, and tablets. Typically, it is applied topically to the affected areas several times a day.

    For people who have a more severe case of oral thrush, an antifungal drug called fluconazole may be prescribed by your healthcare provider as a pill or even given through a vein.

    Gentian violet has also been recommended for oral thrush in the past. However, recent studies indicate that gentian violet can be toxic to the mucous membranes of the mouth and can cause ulcerations and potentially permanently stain the skin. Consult your healthcare professional before using gentian violet, to avoid potential toxicity and side effects.

    A Word From Verywell

    Maintaining good health is generally your best defense against oral thrush. People who have a weaker immune system, such as the very young and very old, are more likely to be affected by oral thrush.

    It’s important to note, however, that people with chronic dry mouth, even if their immune system is functioning well, can also get thrush. Talk to your healthcare professional to make sure oral thrush is causing your symptoms, so treatment can begin so to alleviate your symptoms and discomfort.

    Thrush is a fungal (yeast) infection that can grow in your mouth, throat and other parts of your body. In your mouth thrush appears as a growth that can look like cottage cheese – white, raised lesions on your tongue and cheeks. The condition can quickly become irritated and cause mouth pain and redness.

    Thrush is caused by the overgrowth of a type of fungus called Candida. Mouth and throat thrush is called oropharyngeal candidiasis.

    A thrush infection is annoying but it’s generally a minor problem for healthy people and will clear up in a few weeks with antifungal treatment.

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

    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. Thrush in the esophagus (swallowing tube) is one of the more common infections in people with HIV/AIDS.

    Thrush can be contagious to those at risk (like people with weakened immune systems or are taking certain medications). In healthy people, it’s unusual for it to be passed on through kissing or other close contacts. In most cases, thrush isn’t considered particularly contagious but it can be transmitted.

    If you’re worried about getting thrush from another person who has it, avoid coming into contact with their saliva (spit). It’s smart to wash your hands as often as possible if you’re near someone who has thrush.

    Why is thrush a concern during breastfeeding?

    Because infants are more at risk, getting or giving thrush during breastfeeding is a worry with many moms. It’s a common breastfeeding problem, and in some cases treatment can be tricky.

    Babies with thrush can pass the infection to their mothers. When the infection in a baby’s mouth leads to sore throat and pain, they cry and are irritable during feeding. Mothers (especially if they’re taking antibiotics) may also develop thrush infections around the breasts and nipples and transmit it to their babies.

    When both mom and baby develop thrush they should be treated for the condition at the same time to prevent an ongoing exchange of the infection.

    Symptoms and Causes

    What causes thrush?

    Most people have small amounts of the Candida fungus in the mouth, digestive tract and skin. They are normally kept in check by other bacteria and microorganisms in the body. When illnesses, stress, or medications disturb this balance, the fungus grows out of control and causes thrush.

    Medications that can make yeast flourish and cause infection include:

      .
    • Antibiotics. .

    Candida infection is more likely to develop with:

    • Uncontrolled diabetes.
    • HIV infection.
    • Cancer. .
    • Pregnancy (caused by the hormonal changes that occur with pregnancy).
    • Smoking.
    • Wearing dentures that don’t fit well.

    What are the symptoms of thrush?

    Thrush usually develops suddenly. A common sign is the presence of those creamy white, slightly raised lesions in your mouth — usually on your tongue or inner cheeks. They can also be seen on the roof of your mouth, gums, tonsils or back of your throat. Other symptoms may be:

    • Redness and soreness inside and at the corners of your mouth.
    • Loss of ability to taste.
    • Cottony feeling in your mouth.

    The lesions can hurt and may bleed a little when you scrape them or brush your teeth. In severe cases, the lesions can spread into your esophagus and cause:

    • Pain or difficulty swallowing.
    • A feeling that food gets stuck in the throat or mid-chest area.
    • Fever, if the infection spreads beyond the esophagus.

    Thrush can spread to other parts of the body, including the lungs, liver and skin. This happens more often in people with cancer, HIV or other conditions that weaken the immune system.

    Diagnosis and Tests

    How is thrush diagnosed?

    Your health care provider can usually tell right away if you have thrush by looking for the distinctive white lesions on your mouth, tongue or checks. Lightly brushing the lesions away reveals a reddened, tender area that may bleed slightly. A microscopic exam of tissue from a lesion will confirm whether or not you have thrush (but a physical exam is not always necessary).

    If thrush extends into your esophagus other tests may be needed. Your health care provider might:

    • Take a throat culture (swabbing the back of your throat with sterile cotton and studying the microorganisms under a microscope).
    • Perform an endoscopy of your esophagus, stomach, and small intestine (examining the lining of these body areas with a lighted camera mounted on the tip of a tube passed through these areas).
    • Take X-rays of your esophagus.

    Management and Treatment

    How is thrush treated?

    Healthy kids and adults can be effectively treated for thrush. But the symptoms may be more severe and hard to treat in those with weakened immune systems.

    Antifungal medications (like nystatin) are often prescribed to treat thrush. These medicines are available in tablets, lozenges or liquids that are usually "swished" around in your mouth before being swallowed. Usually, you need to take these medications for 10 to 14 days. Your health care provider will have a specific treatment approach designed for you based on your age and the cause of the infection.

    The presence of Candida infection can be a symptom of other medical problems. Be sure to talk to your health care provider to look for these and set up a treatment plan if needed.

    Prevention

    How can thrush be prevented?

    You can do these things to help you avoid a case of thrush:

    • Follow good oral hygiene practices: Brush your teeth at least twice a day and floss at least once a day.
    • Avoid certain mouthwashes or sprays: These products can destroy the normal balance of microorganisms in your mouth. Talk to your dentist or doctor about which ones are safe to use.
    • See your dentist regularly: This is especially important if you have diabetes or wear dentures.
    • Limit the amount of sugar and yeast-containing foods you eat: Foods such as bread, beer and wine encourage Candida growth.
    • If you smoke, QUIT! Ask your doctor about ways to help you kick the habit.

    Last reviewed by a Cleveland Clinic medical professional on 10/22/2019.

    References

    • The American Academy of Oral Medicine. Oral Yeast Infections (Thrush or Candidiasis) (http://www.aaom.com/oral-yeast-infections) Accessed 11/5/2019.
    • Centers for Disease Control and Prevention. Oropharyngeal/Esophageal Candidiasis (“Thrush”) (http://www.cdc.gov/fungal/diseases/candidiasis/thrush/) Accessed 11/5/2019.
    • Akpan A, Morgan R. Oral candidiasis. Postgraduate Medical Journal. 2002;78(922):455-459. doi:10.1136/pmj.78.922.455. ncbi.nlm.nih.gov (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1742467/) Accessed 11/5/2019.

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