Oral candidiasis is a yeast infection of the mouth, usually by Candida albicans. It is common in infants, denture wearers, people using inhaled steroids or antibiotics, and people with weak immune systems.
Key symptoms
- White patches in the mouth
- Soreness or burning
- Altered taste or a cottony feeling
- Cracks at the corners of the mouth
- Poor feeding in infants
What you find on exam
- Creamy white plaques that wipe off and leave a red base
- Red, sore areas under dentures
- Ask about pain with swallowing (possible spread to the esophagus)
- Look for clues to a weak immune system
Tests
- Diagnosis is usually clinical
- KOH smear showing yeast and hyphae if unclear
- HIV test and glucose if there is no clear cause or it keeps coming back
Treatment basics
- Nystatin suspension or clotrimazole troches for mild cases
- Oral fluconazole for moderate to severe cases
- Rinse the mouth after inhaled steroids
- Clean dentures and take them out at night
Red flags
- Pain with swallowing (esophageal candidiasis)
- Recurrent thrush in an adult without a clear cause (possible HIV or diabetes)
- Infant not feeding or dehydrated
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.