Thrush

Thrush is a disease, which is a cause by infection due to fungus Condide albicans. This organism has been commonly inhabitant of the oral Cavity. Oral Candidiasis or Thrush usually remains a localized disease but on some occasion it may external to the pharynx or even to the lungs.

Types of Thrush

Candidiasis is mainly of two types:

• Mucocutaneous candidiasis
• Systemic candidiasis.

The mucocutaneous form includes oropharyngeal candidiasis, candidal oesophagitis, intestinal candidiasis, candidal vulvovaginitis.

The systemic form of Candidiasis involves mainly the eyes, the kidneys and the skin.

Classification of Oral Candiasis

(A) Acute

1. Acute pseudomembranous oral candidiasis

2. Acute atrophic oral candidiasis.

(B) Chronic

1. Chronic hyperplastic oral candidiasis.

2. Chronic mucocutaneous candidiasis @ Chronic familial mucocutaneous candidiasis.

b). Chronic localized mucocutaneous candidiasis.

c). Candidiasis endocrinopathy syndrome.

d) Chronic diffuse mucocutaneous candidiasis.

3. Chronic atrophic oral candidiasis.

Symptoms of Thrush

In Acute Psecudomembranous candidiasis, the oral lesions are characterized by the appearance of soft, white, slightly elevated plaques most frequently occurring on the buccal mucosa and tongue, but also seen on the palate, gingival and floor of the mouth. The plaque which often have been described grossly as resembling milk curds, consists chiefly of tangled masses of fungal hyphae with intermingled desquamated epithelium, keratin, fibrin, necrotic debris and bacteria. The white plaque can usually be wiped away with a gauze, leaving either a normal appearing mucosa or on erythematous area. In severe cases the entire oral cavity may be involved.

In Acute atrophic Candidiasis the lesions appear as red or erythematous, rather than white. It resembles the Pseudomembranous type only in which the white membrane has been wiped off. It may occur at any site. It is the only variety of oral candidiasis, which is continuously painful.

In Chronic hyperplastic candidiasis, the oral lesions consist of on the lips, tongue and cheeks. These lesions may persist for periods of years. It is often spoken of as the “leukoplakia” type of candidiasis.

In Chronic mucocutaneous candidiasis, the clinical appearance of the lesion is similar to the lesions is similar to the lesions described in chronic hyperplastic candidiasis and occur in same intraoral locations.

In chronic Atrophic Candidiasis a diffuse inflammation of the denture-bearing area is seen which is accompanied with angular cheilitis. It is considered synonymous with the condition better known as “denture sore mouth”.

The Oral Candidiasis or Thrush is also known by some other names, such as Moniliasis. This disease is said to be the most opportunistic infection in the world. It occurrence has been increased remarkably since the prevalent use of antibiotics, which destroys the inhibitory bacterial flora and immunosuppressive drugs, chiefly corticosteroids and cytotoxic drugs.

Treatment of Thrush

The development of new specific antifungal agents such as nystalin has been beneficial in the treatment of candidiasis. Suspension of nystalin, held in contact with the oral lesion, have been successfully used in even chronic, severe cases of the disease. The use of tablets of the fungicide prepared specifically for the treatment of intestinal thrush, are of little value in managing oral lesions, because it is necessary that the drug must make intimate contact with the organisms in order to be effective. Other drugs of value are chlortrimazoles, amphtericin B and iconazole.

It has been found that occasional cases of candidiasis show no positive effect on treatment by nystatin. It is because they are frequently associated with some endocrinopathies, which have immunologic abnormalities

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