Thrush

Thrush is a fungal infection of mucous membranes caused primarily by Candida species, most commonly Candida albicans. In human medicine, thrush most often refers to oral candidiasis, an infection of the mouth and throat. The term can also describe infections of other mucosal surfaces, such as the vagina (vulvovaginal candidiasis) or esophagus, especially in people with weakened immunity. In non-medical contexts, thrush may refer to infections in birds or other animals, but this article focuses on human disease.

Causes and risk factors: Candida species are normally present on the skin and in the mouth and gut in small amounts. Overgrowth can occur after antibiotic use, in diabetes, with immune suppression, or after inhaled corticosteroid use without mouth rinsing. Infants and older adults are particularly susceptible. Symptoms: white, creamy patches on the tongue, inner cheeks, roof of the mouth, or tonsils; redness, soreness, and sometimes a cottony feeling or loss of taste. In vaginal thrush, itching and discharge are common. Severe or esophageal infection may cause pain with swallowing or fever.

Diagnosis and treatment: Diagnosis is usually clinical but can be confirmed by sampling from the affected area. Most cases of oral thrush respond to antifungal medications, typically topical nystatin or clotrimazole, with systemic fluconazole or itraconazole reserved for more severe infections. Rinsing the mouth after inhaled steroids and maintaining good oral hygiene can help prevent recurrence. Prognosis is generally good with treatment, though infections may recur in immunocompromised individuals.