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Thrush - Oral Thrush

Definition
A common fungus infection of the mouth appearing as curdy white membrane on the tongue, lips, gums or inside of the cheeks.

Affects
Newborns and infants, but may also affect older children.

Signs & Symptoms
Patches appear in the mouth with the following characteristics:

  • White to creamy yellow and slightly raised; they are similar to curds, but can't be wiped off.
  • Patches are not painful unless they are rubbed off. Then they leave small, painful ulcers.
  • The mouth is dry.

Causes
The causative fungus is called candida albicans, which a person may acquire under the following circumstances:

  • Treatment with antibiotics- this may upset the natural balance of organisms in the mouth and allow thrush to develop. This is why B complex is always given with antibiotics.
  • Birth- Newborns may acquire the infection during passage through the birth canal--especially if the mother has a vaginal fungal infection. Thrush appears within hours or up to 7 days after birth.

Risk Increases With

  • Poor nutrition.
  • Illness that has lowered resistance.
  • HIV
  • Use of drugs that suppress immunity.

Prevention
If you must give antibiotics to your child, ensure buttermilk or yogurt during treatment to replenish helpful bacteria in the digestive tract.

Diagnostic Measures

  • Observation of symptoms.
  • Medical history and physical exam by a doctor.

Possible Complications
Rarely spreads to vagina, skin, larynx, gastrointestinal tract or respiratory system.

Probable Outcome
Treatment usually clears this infection in 3 days. It is not dangerous or serious, but it has a tendency to recur.

General Measures

  • To avoid transmitting thrush to others, boil eating utensils. Boil anything that touches the mouth or saliva.
  • Rinse the mouth with a salt solution (1/2-teaspoon salt to 250 cc water) 3 times a day or more after eating.
  • If an infant has the infection, boil bottle nipples separately for 20 minutes before the final sterilization.

Medication

  • Gently swab patches of thrush in the mouth with antiseptic mouthwash or non-prescription 1% gentian-violet solution.
  • If these simple medicines don't cure the infection, your doctor may prescribe an antifungal drug to apply to the patches.

Diet
No changes in infants. Older children should maintain an adequate fluid intake with milk, ice cream, custard, water, tea or other beverages and foods that are easy to swallow. Give a straw for drinking if the patches are painful.

Contact Your Doctor

  • Signs of dehydration (sunken eyes, poor elasticity of the skin and lethargy).
  • An infant fails to gain weight or an unexplained weight loss.
  • Fever.
  • Lesions on the skin or vagina.
  • Signs of secondary bacterial infection (pain, redness, tenderness, swelling, and sometimes fever) appear in the mouth.