I. Epidemiology: Common in infants, especially Breast fed

  1. Rare in first week of life
  2. Peaks at 4 weeks of age

II. Risk Factors: Adults with Thrush (Immunodeficiency)

  1. Human Immunodeficiency Virus
  2. Corticosteroid exposure
    1. Prolonged systemic steroids
    2. Inhaled Corticosteroids
  3. Dentures
  4. Xerostomia
  5. Leukemia
  6. Malnutrition
  7. Radiation Therapy
  8. Systemic Chemotherapy
  9. Broad-spectrum antibiotics

III. Risk Factors: Children with chronic Thrush

IV. Risk Factors: Systemic Candidiasis

  1. Acquired ImmunodeficiencyVirus
  2. Diabetes Mellitus
  3. Immunosuppressive Therapy
  4. Malignancy
  5. Neutropenia
  6. Organ transplantation
  7. Prematurity

V. Symptoms

  1. Oral burning sensation

VI. Signs: Typical erythematous Candidiasis

  1. White, curd-like or cottony patches or Plaques
  2. Adherent to erythematous mucosa over Palate
    1. Will not rub off with scraping

VII. Signs: Alternative presentations

VIII. Management

  1. Nystatin
    1. Adults
      1. Pastilles: 200,000 u lozenge qid for 14 days
      2. Swish and swallow: 500,000 u qid for 14 days
      3. Tablets: Two 500,000 u tablets tid for 14 days
    2. Children
      1. Suspension (100,000 u/ml): Swab 1 ml on each cheek
  2. Miconazole gel
    1. Not currently available in U.S.
  3. Clotrimazole troche (Mycelex)
    1. Adults
      1. Troche: 10 mg five times daily for 14 days
      2. Vaginal Suppository: 100 mg qd to bid for 14 days
    2. Adverse Effects
      1. May raise Liver Function Tests
      2. Gastrointestinal Side effects
  4. Fluconazole
    1. Adults
      1. Initial: 200mg PO for 1 dose
      2. Later: 100 mg daily for 5-7 days
    2. Children
      1. Protocol 1: 5 mg/kg PO qd for 5 days
      2. Protocol 2: 6-12 mg/kg day 1, then 3-6 mg/kg for 10 days
        1. Chetwynd (2002) J Hum Lact 18:168-71 [PubMed] (or open in [QxMD Read])
  5. Amphotericin B Oral Suspension
    1. Adults with HIV: 3-5 ml PO qid
    2. Indicated for refractory oropharyngeal Candidiasis
  6. Other treatments used historically
    1. Gentian Violet?
    2. Homemade Recipe
      1. 2 drops of dish soap
      2. 1/4 tsp baking soda
      3. Glass of warm water
      4. Apply to roof of mouth w/ cotton applicator qid

Images: Related links to external sites (from Google)

Ontology: Candidiasis (C0006840)

Definition (NCI) A condition in which Candida albicans, a type of yeast, grows out of control in moist skin areas of the body. It is usually a result of a weakened immune system, but can be a side effect of chemotherapy or treatment with antibiotics. Thrush usually affects the mouth (oral thrush); however, rarely, it spreads throughout the entire body.
Definition (MSH) Infection with a fungus of the genus CANDIDA. It is usually a superficial infection of the moist areas of the body and is generally caused by CANDIDA ALBICANS. (Dorland, 27th ed)
Definition (CSP) infection with a fungus of the genus Candida; usually a superficial infection of the moist areas of the body and is generally caused by Candida albicans; includes chronic mucocutaneous candidiasis, cutaneous candidiasis, oral candidiasis (thrush), and monilial vaginitis.
Concepts Disease or Syndrome (T047)
MSH D002177
ICD9 112.9, 112
ICD10 B37 , B37.9
SnomedCT 187005005, 154403005, 187478002, 187024008, 78048006
English Candidiases, Candidiasis, Moniliases, Moniliasis, Candidiasis of unspecified site, CANDIDIASIS, MONILIASIS, Candidiasis, NOS, Candidosis, NOS, Moniliasis, NOS, Candidiasis NOS, Candidiasis, unspecified, [X]Candidiasis, unspecified, MONILIASIS MONILIA, candidiasis, candidiasis (diagnosis), muguet, E-410 CANDIDIASIS, Candida NOS, Candida infections, Monilial infection, Monilia NOS, Moniliasis monilia, Moniliasis NOS, [X]Candidiasis, unspecified (disorder), Candidiasis site NOS, Candidiasis NOS (disorder), candidosis, Candidiasis [Disease/Finding], candidal infection, candidal infections, monilial infection, candida infections, candidiases, candida infection, monilia infection, thrush, Candidal infection NOS, Candidosis, Infection by Candida species, Candida infection, Monilia infection, Candidiasis (disorder), moniliasis, candida; infection, Muguet, infection; candidal, infection; monilia, monilia; infection
French CANDIDOSE, MONILIASE, Infection candidosique, Moniliase SAI, Infection à Candida SAI, Candidose SAI, Moniliase à Candida, Candidiase SAI, Candida SAI, Candidose de site non précisé, Candidoses, Candidiase, Candidose, Moniliase, Moniliose
Portuguese CANDIDIASE, MONILIASE, Candidíase de local NE, Candida NE, Candidíase NE, Monilíase NE, Monilia NE, Infecção por monilia, Monilia de monilíase, Infecção por cândida NE, Candidiase, Infecções a Candida, Candidíase, Monilíase
Spanish CANDIDIASIS, MONILIASIS, Moniliasis NEOM, Cándida NEOM, Infección por Candida NEOM, Monilia NEOM, Candidiasis NEOM, Candidiasis de localización no especificada, Infección monilial, Candidiasis, Moniliasis, Candidosis, Candida infection, Monilia infection, [X]candidiasis, no especificada (trastorno), [X]candidiasis, no especificada, candidiasis (trastorno), candidiasis, SAI (trastorno), candidiasis, SAI, candidiasis, candidosis, infección por especies de Candida, moliniasis, SAI, moniliasis, Infecciones por cándida
Italian Candidiasi, Infezioni da candida, Candidiasi / Candida, Infezione da Candida, Candidiasi NAS, Infezione da Candida NAS, Candida NAS, Candidiasi di sede non specificata, Moniliasi, Candidosi
Dutch Candida NAO, candidiasis op niet-gespecificeerde plaats, candidiasis NAO, Monilia-infectie, moniliasis NAO, moniliasis, moniliasis Monilia, Candida-infectie NAO, Monilia NAO, Monilia; infectie, candida; infectie, infectie; Monilia, infectie; candida, Candidiasis, niet gespecificeerd, Candida-infecties, candidiasis, Candidiasis, Moniliasis
German Candida NNB, Candidainfektion NNB, Moniliasis NNB, Moniliasis durch Monilia, Candidiasis NNB, Monilioseinfektion, Candidiasis unspezifischer Stelle, CANDIDIASIS, Kandidose, nicht naeher bezeichnet, MONILIASIS, Candida-Infektionen, Candida-Mykosen, Candidose, Kandidose, Moniliasis, Soor, Candidiasis
Japanese カンジダ感染, モニリア感染, カンジダNOS, 部位不明のカンジダ症, モニリアNOS, モニリア症NOS, カンジダ症NOS, カンジダ感染NOS, モニリアショウ, カンジダカンセンNOS, カンジダNOS, カンジダショウ, ブイフメイノカンジダショウ, モニリアNOS, モニリアカンセン, モニリアショウNOS, カンジダカンセン, カンジダショウNOS, カンジダ症, カンジダ感染症, モニリア症
Swedish Kandidos
Czech kandidóza, Kandidová infekce, Kandidová infekce NOS, Kandidové infekce, Moniliáza NOS, Kandidóza, Moniliáza, Kandidóza na blíže neurčeném místě, Kandidy NOS, Kandida NOS, Kandidóza NOS
Finnish Kandidiaasi
Korean 상세불명의 칸디다증, 칸디다증
Polish Kandidiaza, Zakażenie Candida albicans, Moniliaza, Oidiomikoza, Bielnica, Kandydoza
Hungarian Moniliasis monilia, Candida fertőzések, candidiasis k.m.n., candidiasis, Moniliazisos fertőzés, Candida k.m.n., moniliasis, Candidás fertőzés k.m.n., moniliasis k.m.n., Nem meghatározott elhelyezkedésű candidiasis, Monilia k.m.n.

Ontology: Oral candidiasis (C0006849)

Definition (MSH) Infection of the mucous membranes of the mouth by a fungus of the genus CANDIDA. (Dorland, 27th ed)
Concepts Disease or Syndrome (T047)
MSH D002180
ICD9 112.0
ICD10 B37.0 , B37.9
SnomedCT 367093001, 78048006, 79740000, 187005005, 187006006
English Candidiases, Oral, Candidiasis, Oral, Moniliases, Oral, Moniliasis, Oral, Oral Candidiases, Oral Moniliases, Thrush, ORAL MONILIASIS, CANDIDIASIS, ORAL, Candidiasis, oral, MONILIASIS ORAL, MOUTH CANDIDA INFECTION, ORAL THRUSH, Oral Moniliasis, STOMATITIS MONILIAL, THRUSH, Oral candidiasis, Candidal stomatitis, thrush (disorder), mycotic stomatitis, oral candidiasis (diagnosis), oral thrush, oral candidiasis, candidiasis oral thrush, Oral candidiasis (disorder), Candida of mouth, Oral candida, Candida stomatitis, Stomatitis monilial, Moniliasis oral, Thrush oral, Thrush NOS, STOMATITIS CANDIDA, ORAL CANDIDIASIS, Candidiasis, Oral [Disease/Finding], Candidiasis;oral, Thrush;oral, Candidiasis of mouth, Mycotic stomatitis, Candida infection of mouth, Candidosis of mouth, Moniliasis of mouth, Oral candidosis, Oral moniliasis, Oral thrush, Candidiasis of mouth (disorder), candida; thrush, oral, candidiasis; mouth, candidiasis; stomatitis, candidiasis; thrush, monilia; stomatitis, mouth; candidiasis, mycosis; stomatitis, mycotic; stomatitis, sprue; candidal, oral, stomatitis; candidal, stomatitis; monilia, stomatitis; mycosis, stomatitis; mycotic, Oral Candidiasis, Thrush, oral, thrush
French MUGUET, Moniliase buccale, Muguet, Candida oral, Infection buccale à Candida, Stomatite candidosique, Muguet SAI, Stomatite à Candida, Candidose de la bouche, Muguet buccal, Muguet oral, MONILIASES ORALE, Muguet (maladie), Blanchet, Candidose buccale, Moniliase orale, Stomatite à candida, Candidose orale
Italian Candidiasi orale, Mughetto orale, Stomatite da candida, Candidiasi della bocca, Candidiasi NAS, Candida orale, Candidiasi, Candidiasi dela bocca, Mughetto, Moniliasi orale, Candidosi orale
Dutch moniliasis oraal, orale moniliasis, spruw oraal, orale Candida, Candida van de mond, thrush, orale spruw, spruw NAO, Monilia-stomatitis, candidiasis van de mond, Monilia; stomatitis, candida; spruw, oraal, candidiasis; mond, candidiasis; spruw, candidiasis; stomatitis, mond; candidiasis, mycose; stomatitis, mycotisch; stomatitis, spruw; candida, oraal, stomatitis; Monilia, stomatitis; candida, stomatitis; mycose, stomatitis; mycotisch, orale candidiasis, Candida-stomatitis, Candidiasis, orale, Moniliasis, orale, Orale candidiasis, Spruw
German Candidose des Mundes, orale Candida, candida-bedingte Stomatitis, orale Moniliose, Soor, Moniliose oral, Candida des Mundes, Soor NNB, Stomatitis durch Candida, CANDIDIASIS MUND, Candida-Stomatitis, SOOR, orale Candidose, Candidose, orale, Kandidose, orale, Moniliasis, orale, Mundsoor
Portuguese Candidíase da boca, Estomatite por monilia, Candida oral, Sapinhos da boca, Candidíase NE, Monilíase oral, Candidíase, Estomatite por Candida, AFTA, MONILIASE ORAL, Candidíase Oral, Candidíase oral, Candidíase Bucal, Monilíase Bucal, Sapinho
Spanish Candidiasis de boca, Moniliasis oral, Cándida oral, Estomatitis moniliásica, Candidiasis NEOM, Estomatitis por cándida, Cándida de boca, Candidiasis, Oral candidiasis, Thrush, Oral moniliasis, CANDIDIASIS ORAL, Candidiasis Oral, candidiasis de la boca (trastorno), candidiasis de la boca, candidiasis oral, candidiosis oral, estomatitis micótica, moniliasis oral, muguet, Candidiasis oral, Muguet, Candidiasis Bucal, Moniliasis Oral
Japanese 口腔カンジダ, カンジダ症, モニリア性口内炎, カンジダ症NOS, カンジダ性口内炎, コウクウカンジダショウ, カンジダセイコウナイエン, コウクウカンジダ, ガコウソウ, カンジダショウ, カンジダショウNOS, コウクウモニリアショウ, モニリアセイコウナイエン, カンジダ症-口腔, コウコウモニリアショウ, がこう瘡, 口腔カンジダ症, 口腔モニリア症, 鵞口瘡, モニリア症-口腔, 口腔内カンジダ症
Swedish Kandidos, oral
Czech kandidóza orální, Moučnivka dutiny ústní, Ustní kandidóza, Moučnivka NOS, Kandidová stomatitida, Orální kandidóza, Orální moniláza, Moučnivka, Orální moniliáza, Kandidová infekce úst, Kandidová infekce dutiny ústní, Orální moučnivka
Finnish Sammas
Korean 칸디다 입안염
Polish Kandydoza jamy ustnej
Hungarian Candidás stomatitis, Száj candidiasisa, szájpenész, moniliasis oris, Oralis moniliasis, Penész k.m.n., oralis candidiasis, Oralis candida, szájüregi candidiasis, Stomatitis moniliazisos, Penész