Otolaryngology Book

http://www.fpnotebook.com/

ThrushAka: Oral Candidiasis, Candida Albicans Pharyngitis

Advertisement

  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 Immunodeficiency Virus
    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
    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

Candidiasis (C0006840)

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.
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.
ConceptsDisease or Syndrome (T047)
ICD9112, 112.9
MSHD002177
EnglishCandida infection, Candidiases, Candidiasis, Candidiasis of unspecified site, Candidosis, Infection by Candida species, Monilia infection, Moniliases, Moniliasis, MONILIASIS MONILIA, muguet, Thrush
Spanishcandidiasis, candidosis, infeccion por especies de Candida, moniliasis
Parent ConceptsMycoses (C0026946), Opportunistic Infections (C0029118), Sexually Transmitted Diseases (C0036916), Infection (C0021311), Disorders, General, Functional and NEC (C0549512), Candidiasis (C0006840), Infection by Deuteromycetes (C0276698), Duplicate concept (C1274013)
SourcesAOD, COSTAR, CSP, CST, DXP, ICD9CM, LCH, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



Navigation Tree