27/10/2025
Oral candidiasis (also called **oral thrush**)
is a **fungal infection** of the mouth caused primarily by *Candida albicans*, though other *Candida* species (e.g., *C. glabrata*, *C. tropicalis*) can also be responsible.
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🦠 Etiology (Causes)
*Normal flora imbalance:
Candida is a normal commensal organism in the mouth; overgrowth occurs when local or systemic defenses are weakened.
Predisposing factors:
Local factors:
* Poor oral hygiene
* Denture use (especially if not cleaned properly)
* Xerostomia (dry mouth)
* Use of topical steroids (e.g., inhalers for asthma)
Systemic factors:
* Diabetes mellitus
* Immunosuppression (e.g., HIV/AIDS, chemotherapy)
* Broad-spectrum antibiotics
* Malnutrition (especially iron, folate, or vitamin B12 deficiency)
* Infancy or old age (weaker immunity)
🧫 Diagnosis
Clinical appearance (often diagnostic)
1. Microscopy: KOH smear shows budding yeast and pseudohyphae.
2. Culture: Sabouraud’s dextrose agar.
Other tests:
Periodic acid–Schiff (PAS) staining, germ tube test for C. albicans
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💊 Treatment
1. Address predisposing factors:
* Improve oral hygiene
* Remove or disinfect dentures overnight
* Rinse mouth after steroid inhaler use
* Control diabetes or immunosuppressive conditions
2. Antifungal therapy:
Topical:
1. Nystatin oral suspension (100,000 U/mL) – rinse and swallow 4×/day
2. Clotrimazole troches (10 mg) – dissolve 5×/day
Systemic (for severe or resistant cases):
1. Fluconazole 100–200 mg daily for 7–14 days
2. Itraconazole or ketoconazole (less preferred due to hepatotoxicity)
Complications
* Persistent infection may indicate underlying immunodeficiency (e.g., HIV)
* Chronic forms can predispose to dysplastic or malignant changes (rare)