ICD-9: 111.20


Thrush is a yeast infection of the mucus membrane lining of the mouth and tongue. It is commonly seen in infants but occurs in individuals with diabetes, those taking antibiotics for a long period of time, individuals with poorly fitting dentures, and those receiving chemotherapy treatments. Persons with HIV or AIDS are susceptible, also.


When the immune system is weakened, the small amount of Candida fungus normally living in the mouth grows unchecked and becomes a problem. The “sweet” saliva in the mouth of diabetics feeds the Candida, and long-term use of antibiotics destroys healthy bacteria that prevents its growth.


Signs and Symptoms

Thrush appears as whitish, velvety lesions in the mouth and on the tongue. The tissue underneath the lesions easily bleeds. The lesions gradually increase in number and size. It is painful to eat or swallow.

Diagnostic Procedures

Diagnosis is easily determined by a primary care provider or dentist looking at the mouth and tongue. Microscopic examination of mouth scrapings or culture of mouth lesions may be performed to confirm the Candida organisms.


Infants with thrush are seldom treated, because thrush disappears in less than 2 weeks. For others, eating yogurt or taking over-the-counter acidophilus capsules can help. Controlling blood sugar levels for diabetics is often sufficient to clear up the problem. An antifungal mouthwash (nystatin) or lozenges (clotrimazole) to suck on may be prescribed for those with weakened immune systems. In severe cases, when the infection spreads throughout the body, medications such as fluconazole (Diflucan) or ketoconazole (Nizoral) may be ordered.

READ:   Lung abscess

Complementary Therapy

Rinsing the mouth and using a soft toothbrush with diluted 3% hydrogen peroxide solution several times a day is beneficial.


Thrush is uncomfortable. Remind clients with weakened immune systems to report any outbreak, as it may be advantageous to recommend taking antifungal medication on a regular basis to avoid recurrent infections.


Candida can spread throughout the body when unchecked, causing complications including esophagitis, meningitis, endocarditis, and endophthalmitis.


Sterilize or discard any pacifiers or bottle nipples to prevent reinfection. Replace toothbrushes often, and take antifungal medications when the immune system is weakened by other disease.

PHARYNGITIS ICD-9: 462 Description Pharyngitis, inflammation of the pharynx, is the most common throat disorder and may be acute or chronic. On the average, children experience sore throats about five times a year, adults twice a year. Etiology Acute pharyngitis can be caused by any of a number of bacterial or viral infections, with viral infections being the most common. Streptococcus pyogenes (causing strep throat) is the most common of many possible bacterial pathogens; influenza virus and common cold viruses are the most common viral pathogens causing the condition. Acute pharyngitis also may arise secondary to systemic viral infections, such as measles or chickenpox. Noninfectious causes of the disease include trauma to the mucosa of the pharynx from heat, sharp objects, or chemical irritants. Chronic pharyngitis is more likely to have a noninfectious origin and is often associated with persistent cough or allergy. Signs and Symptoms The hallmark of acute pharyngitis is sore t...
Understanding Nosebleeds Nosebleed, or epistaxis, is more likely a symptom than a disorder or disease. Bleeding from the nose is more common in winter months that are likely cold and dry. It is more common in children and older adults. Nosebleeds are usually not considered serious, but some circumstances call for medical attention by a health-care professional because of possible underlying causes. They are: Repeated nosebleeds Syncope Hematemesis or hemoptysis Nosebleeds commonly occur due to nose picking or nose trauma but may be secondary to rhinitis, hypertension, chemotherapy treatment, certain illnesses, and blood-thinning medications. Secondary nosebleeds should be reported to a medical professional. To treat a nosebleed, have the client lean forward and press the soft portion of the nostrils against the septum for 10 minutes (pinch the nose). Apply cold, wet compresses. A vasoconstricting agent such as epinephrine on a cotton ball may be applied to the bleeding site. Cauterization or petr...
Acute tonsillitis ICD-9: 463 Description Acute tonsillitis is inflammation of a tonsil, especially one or both of the palatine tonsils that lie on either side of the opening of the throat. It can be acute or chronic. Etiology Tonsillitis is most frequently caused by infection by the bacteria Streptococcus pyogenes or Staphylococcus aureus, although a variety of infectious agents may be involved. The condition is a common complication of pharyngitis. Signs and Symptoms Acute tonsillitis is typically manifested by the sudden onset of chills and a high-grade fever with a mild to severe sore throat. Additional symptoms may include malaise, headache, and dysphagia. Chronic tonsillitis causes a recurrent sore throat, tonsillar hypertrophy, and abscess. Diagnostic Procedures On physical examination, the tonsils appear red and swollen. In severe cases, abscesses may be visible on the affected tonsil’s surface. Blood tests may reveal leukocytosis. A throat culture to detect bacteria typical...
ASTHMA ICD-9: 493.9x* Description Asthma is a respiratory condition marked by recurrent attacks of labored breathing accompanied by wheezing. Asthma is an inflammatory disorder of the airways that causes spasms of the bronchial tubes or swelling of their mucous membranes. Extrinsic asthma occurs when the bronchospasm is the result of an allergic response to environmental irritants. Intrinsic asthma is present when the client suffers attacks without evidence of allergic response. Extrinsic asthma is most common in childhood; intrinsic asthma more often begins in adulthood. Asthma affects 22 million Americans, of whom 6 million are children under age 12. Etiology The etiology of asthma is uncertain. There is often a family history of allergy and an individual history of hypersensitivity. Persons with asthma have very sensitive airways that react to “triggers” that cause asthma symptoms to start or worsen. Common triggers include upper respiratory infections; allergens, such as pollens...
Pulmonary hypertension ICD-9: 518.82 Description Pulmonary hypertension occurs when the pulmonary arteries and capillaries become narrowed or blocked, making the blood flow through the lungs difficult. As the pulmonary arteries’ blood pressure rises, the right ventricle of the heart must work harder to pump the blood through the lungs. This causes the heart muscle to weaken. Etiology Pulmonary hypertension is either primary (idiopathic) or secondary. Primary pulmonary hypertension (PPH) has no underlying cause, although there may be a genetic predisposition. Secondary pulmonary hypertension is the result of an underlying problem, such as COPD, pulmonary embolus, sleep apnea, chronic liver disease, and AIDS. Older adults are more at risk, as are those who live above an altitude of 8000 feet. Those who climb at high altitudes may develop a temporary form of pulmonary hypertension called transient reversible pulmonary hypertension unless they first acclimate to the altitude. Signs and Symptoms S...