![]() ![]() Although this type of candidiasis is less common, diagnosis may be difficult, but should be considered in the differential diagnosis of a sore tongue, especially in a frail, older patient with dentures who has received antibiotic therapy or who is on inhaled steroids. The tongue may be bright red and painful. See Box for preventative strategies for oral candidiasis Īcute atrophic candidiasis is associated with a burning sensation in the mouth or on the tongue, and often referred to as ‘antibiotic sore mouth’, because of its association with prolonged use of broad-spectrum antibiotics Patients should be counselled on good dental hygiene on initiation of corticosteroid inhalers If thrush is associated with the use of corticosteroid inhalers, rinsing the mouth with water (or cleaning a child’s teeth if not able to rinse and spit) immediately after using the inhaler may avoid the problem. The plaque can usually be scraped off to expose an underlying erythematous mucosa Pseudomembranous candidiasis is the most common type and is characterised by an extensive white ‘cottage cheese-like’ film, found on the buccal mucosa, tongue, periodontal tissues and oropharynx, There are several classifications of oral candidiasis, and their similarities and differences are outlined below, Source: Science Photo Library Classification It provides assistance in recognising patients at risk of mucosal fungal infections, and the pharmacological and non-pharmacological options to prevent occurrence and treat the infection.įigure 1: an example of mild pseudomembranous candidiasis (white areas) This article aims to aid pharmacists in the diagnosis and management of patients suffering from oral candidiasis. More than half a million prescriptions for oral Candida infections are issued each year in England by GPs A tertiary care hospital reported that, of their patients suffering from Candida bloodstream infection, 45% received immunosuppressive therapy However, in severely immunosuppressed patients, invasive and life-threatening systemic Candida infection may develop. ![]() While not life-threatening for most patients, it can cause significant patient discomfort and, in elderly or hospitalised patients, can result in significant morbidity owing to impaired nutrition corticosteroids, azathioprine, methotrexate), and with increased immunosuppressive comorbidities, including diabetes, cancer and AIDS, there has been an increase in the number of reported cases of opportunistic oral Candida infections penicillins, fluoroquinolones, macrolides) and immunosuppressive agents (e.g. With increased availability and prescribing of broad-spectrum antibacterials (e.g. It is unclear why the carriage rate varies with age. In neonates it is 45% in healthy children 45–65% in healthy adults 30–45% in denture wearers 50–65% in patients living in acute or long-term facilities, such as nursing or residential homes, 65–88% and in immunocompromised patients, such as those with HIV and/or undergoing chemotherapy for acute leukaemia, it is 95% and 90% respectively, albicans) accounts for around 80% of infections and can colonise the cavity, either alone or in combination with non-albican species, including Candida glabrata and Candida Oral candidiasis is an opportunistic infection of the oral cavity often caused by the overgrowth of Candida, a yeast-like fungus commonly found in the gastrointestinal tract of humans, as normal skin flora and in mucous membranes Journal of Pharmaceutical Health Services Research.International Journal of Pharmacy Practice.Antimicrobial resistance and stewardship. ![]()
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