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]
  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

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Ontology: Candidiasis (C0006840)

Definition (NCI_NCI-GLOSS) 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, 187024008, 187478002, 154403005, 370520002, 78048006
English Candidiases, Candidiasis, Moniliases, Moniliasis, CANDIDIASIS, MONILIASIS, Candidiasis, unspecified, [X]Candidiasis, unspecified, candidiasis, candidiasis (diagnosis), Candida infections, Candidiasis site NOS, candidosis, Candidiasis [Disease/Finding], candidal infection, candidal infections, monilial infection, thrush, candida infections, candidiases, candida infection, muguet, monilia infection, Candidiasis NOS (disorder), [X]Candidiasis, unspecified (disorder), Candida NOS, Monilial infection, Moniliasis monilia, Moniliasis NOS, Candidiasis of unspecified site, Monilia NOS, Candidal infection NOS, Candidiasis NOS, Thrush, Candidosis, Infection by Candida species, Candida infection, Monilia infection, Candidiasis (disorder), moniliasis, candida; infection, Muguet, infection; candidal, infection; monilia, monilia; infection, Candidiasis, NOS, Candidosis, NOS, Moniliasis, NOS
French CANDIDOSE, MONILIASE, Infection candidosique, Infection à Candida, Candidiase SAI, Candidose SAI, Candida SAI, Infection à Candida SAI, Moniliase SAI, Candidose de site non précisé, Moniliase à Candida, Candidoses, Candidiase, Candidose, Moniliase, Moniliose
Portuguese CANDIDIASE, MONILIASE, Candidíase NE, Candidiase, Monilia NE, Candida NE, Monilia de monilíase, Infecção por Candida, Infecção por cândida NE, Candidíase de local NE, Infecção por monilia, Monilíase NE, Infecções a Candida, Candidíase, Monilíase
Spanish CANDIDIASIS, MONILIASIS, [X]candidiasis, no especificada (trastorno), moliniasis, SAI, candidiasis, SAI, candidiasis, SAI (trastorno), [X]candidiasis, no especificada, Infección por Candida NEOM, Infección por Cándida, Cándida NEOM, Candidiasis NEOM, Moniliasis NEOM, Candidiasis de localización no especificada, Monilia NEOM, Infección monilial, candidiasis (trastorno), candidiasis, candidosis, infección por especies de Candida, moniliasis, Infecciones por cándida, Candidiasis, Moniliasis
Italian Infezioni da candida, Moniliasi, Infezione da Candida, Candidiasi / Candida, Candidiasi NAS, Candida NAS, Candidiasi, Candidiasi di sede non specificata, Infezione da Candida NAS, Candidosi
Swedish Kandidos
Czech kandidóza, Kandidové infekce, moniliáza, Kandidy NOS, Kandidóza, Moniliáza, Kandidóza na blíže neurčeném místě, Kandidová infekce, Kandidová infekce NOS, Infekce způsobená Candida, Kandida NOS, Kandidóza NOS, Moniliáza NOS
Finnish Kandidiaasi
German CANDIDIASIS, Kandidose, nicht naeher bezeichnet, MONILIASIS, Candidiasis unspezifischer Stelle, Candida NNB, Moniliasis NNB, Candidainfektion NNB, Candida-Infektion, Candidiasis NNB, Monilioseinfektion, Moniliasis durch Monilia, Candida-Infektionen, Candida-Mykosen, Candidose, Kandidose, Moniliasis, Soor, Candidiasis
Korean 상세불명의 칸디다증, 칸디다증
Polish Kandidiaza, Zakażenie Candida albicans, Moniliaza, Oidiomikoza, Bielnica, Kandydoza
Hungarian Candida fertőzések, moniliasis k.m.n., Moniliazisos fertőzés, candidiasis, moniliasis, Moniliasis monilia, candidiasis k.m.n., Candida k.m.n., Nem meghatározott elhelyezkedésű candidiasis, Candida fertőzés, Monilia k.m.n., Candidás fertőzés k.m.n.
Japanese カンジダ症, カンジダ感染症, カンジダカンセン, カンジダショウ, カンジダショウNOS, モニリアNOS, カンジダ感染, カンジダ症NOS, モニリア感染, カンジダNOS, ブイフメイノカンジダショウ, カンジダ感染NOS, モニリアカンセン, カンジダNOS, モニリアNOS, カンジダカンセンNOS, モニリアショウ, 部位不明のカンジダ症, モニリア症NOS, モニリアショウNOS, モニリア症
Norwegian Candidainfeksjoner, Candidose, Kandidose, Candidiasis, Moniliase, Moniliasis
Dutch Monilia NAO, candidiasis NAO, moniliasis Monilia, moniliasis NAO, Candida-infectie NAO, candidiasis op niet-gespecificeerde plaats, Monilia-infectie, moniliasis, Candida-infectie, candidiasis, Candida NAO, Monilia; infectie, candida; infectie, infectie; Monilia, infectie; candida, Candidiasis, niet gespecificeerd, Candida-infecties, Candidiasis, Moniliasis

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 79740000, 187006006, 187005005, 367093001, 78048006
English Candidiases, Oral, Candidiasis, Oral, Moniliases, Oral, Moniliasis, Oral, Oral Candidiases, Oral Moniliases, Thrush, MONILIASIS ORAL, Oral Moniliasis, THRUSH, Oral candidiasis, Candidal stomatitis, thrush (disorder), mycotic stomatitis, oral candidiasis (diagnosis), oral thrush, oral candidiasis, candidiasis oral thrush, Oral candida, Candida stomatitis, Stomatitis monilial, Moniliasis oral, Thrush oral, Candidiasis, Oral [Disease/Finding], Candidiasis;oral, Thrush;oral, Candida of mouth, Oral candidiasis (disorder), Thrush NOS, 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, Candida oral, Infection buccale à Candida, Stomatite candidosique, Stomatite à Candida, Candidose de la bouche, Muguet buccal, Muguet oral, MONILIASES ORALE, Muguet (maladie), Muguet SAI, Muguet, Blanchet, Candidose buccale, Moniliase orale, Stomatite à candida, Candidose orale
Italian Candidiasi orale, Mughetto orale, Stomatite da candida, Candidiasi della bocca, Candida orale, Candidiasi dela bocca, Mughetto, Moniliasi orale, Candidiasi, Candidiasi NAS, Candidosi orale
Dutch moniliasis oraal, orale moniliasis, spruw oraal, orale Candida, Candida van de mond, orale spruw, Monilia-stomatitis, candidiasis van de mond, thrush, spruw NAO, 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, Moniliose oral, Candida des Mundes, Stomatitis durch Candida, CANDIDIASIS MUND, Candida-Stomatitis, SOOR, Soor NNB, Soor, orale Candidose, Candidose, orale, Kandidose, orale, Moniliasis, orale, Mundsoor
Portuguese Candidíase da boca, Estomatite por monilia, Candida oral, Sapinhos da boca, Monilíase oral, Estomatite por Candida, AFTA, MONILIASE ORAL, Candidíase, Candidíase NE, Candidíase Oral, Candidíase oral, Candidíase Bucal, Monilíase Bucal, Sapinho
Spanish Candidiasis de boca, Moniliasis oral, Cándida oral, Estomatitis moniliásica, Estomatitis por cándida, Cándida de boca, CANDIDIASIS ORAL, candidosis oral, Candidiasis NEOM, Candidiasis, 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, モニリア性口内炎, 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, 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, カンジダショウNOS, カンジダショウ, カンジダ症, カンジダ症NOS, 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
Finnish Sammas
Czech Moučnivka dutiny ústní, Ustní kandidóza, Kandidová stomatitida, Orální kandidóza, Orální moniláza, Orální moniliáza, Kandidová infekce úst, Kandidová infekce dutiny ústní, Orální moučnivka, orální kandidóza, kandidóza orální, moučnivka, orální moniliáza, soor, Moučnivka NOS, Moučnivka
Korean 칸디다 입안염
Polish Kandydoza jamy ustnej
Hungarian Candidás stomatitis, Száj candidiasisa, szájpenész, moniliasis oris, Oralis moniliasis, oralis candidiasis, Oralis candida, szájüregi candidiasis, Stomatitis moniliazisos, Penész, Penész k.m.n.
Norwegian Candidastomatitt, Oral candidose, Oral kandidose, Oral moniliase, Oral candidainfeksjon, Oral candidiasis, Munntrøske, Oral moniliasis