Thrush

ICD-9: 111.20

Description

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.

Etiology

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.

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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.

Treatment

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.

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Complementary Therapy

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

CLIENT COMMUNICATION

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.

Prognosis

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

Prevention

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.

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