Otolaryngology Book

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Thrush

Aka: Thrush, Oral Candidiasis, Candida Albicans Pharyngitis
  1. Epidemiology: Common in infants, especially Breast fed
    1. Rare in first week of life
    2. Peaks at 4 weeks of age
  2. 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
  3. Risk Factors: Children with chronic Thrush
    1. Hypoparathyroidism
    2. Addison's Disease
    3. Hypothyroidism
    4. Diabetes Mellitus
  4. Risk Factors: Systemic Candidiasis
    1. Acquired ImmunodeficiencyVirus
    2. Diabetes Mellitus
    3. Immunosuppressive Therapy
    4. Malignancy
    5. Neutropenia
    6. Organ transplantation
    7. Prematurity
  5. Symptoms
    1. Oral burning sensation
  6. 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
  7. Signs: Alternative presentations
    1. Median Rhomboid Glossitis
    2. Perleche (Angular Cheilitis)
  8. 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
    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
  9. Reference
    1. Hoppe (1997) Pediatr Infect Dis J 16:885-94

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, ｶﾝｼﾞﾀﾞｶﾝｾﾝNOS, ｶﾝｼﾞﾀﾞNOS, ｶﾝｼﾞﾀﾞｼｮｳ, ﾌﾞｲﾌﾒｲﾉｶﾝｼﾞﾀﾞｼｮｳ, ﾓﾆﾘｱNOS, ﾓﾆﾘｱｶﾝｾﾝ, ﾓﾆﾘｱｼｮｳNOS, ｶﾝｼﾞﾀﾞｶﾝｾﾝ, ｶﾝｼﾞﾀﾞｼｮｳ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
Russian KANDIDOZ, MONILIAZ, КАНДИДОЗ, МОНИЛИАЗ
Korean 상세불명의 칸디다증, 칸디다증
Croatian KANDIDIJAZA
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.
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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