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Revision as of 19:25, 28 March 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Candidiasis of the mouth and throat is a fungal infection that occurs when there is overgrowth of a yeast called candida. Candida yeasts normally live on the skin or mucous membranes in small amounts. However, if the environment inside the mouth or throat becomes imbalanced, the yeasts can multiply and cause symptoms. Candida overgrowth can also develop in the esophagus, and this is called candida esophagitis, or esophageal candidiasis.
Pathophysiology
Candida species are normal inhabitants of the mouth, throat, and the rest of the gastrointestinal tract. Usually, candida yeasts live in and on the body in small amounts and do not cause any harm. However, the use of certain medications or a weakening of the immune system can cause Candida to multiply, which may cause symptoms of infection.
Causes
Oral candidiasis is an infection of yeast fungus, Candida albicans, (or, less commonly, Candida glabrata or Candida tropicalis or C. parapsilosis or C. krusei or other candida species) in the mucous membranes of the mouth.
Natural History, Complications and Prognosis
There are no sequela with appropriate antifungal therapy. In contrast, among immunocompromised patients with disseminated infections, the mortality rate is almost 50%. 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, a pediatrician should be notified. In adults, thrush that occurs in the mouth can be cured. However, the long-term outlook is dependent on immune status and the cause of the immune deficit.
If you have a weakened immune system (for example, if you are HIV-positive or receiving chemotherapy), Candida can spread throughout your body, causing infection in your esophagus (esophagitis), brain (meningitis), heart (endocarditis), joints (arthritis), or eyes (endophthalmitis).
Treatment
Primary Prevention
Good oral hygiene practices may help to prevent oral thrush in people with weakened immune systems. Some studies have shown that chlorhexidine (CHX) mouthwash can help to prevent oral candidiasis in people undergoing cancer treatment. People who use inhaled corticosteroids may be able to reduce the risk of developing thrush by washing out the mouth with water or mouthwash after using an inhaler.