Thrush

Thrush is an infection caused by yeast called Candida. Small amounts of Candida live commonly in the mouth and around the vaginal area. Other areas of the body that are prone to Candida infection include the groin and the nappy area of babies. The immune system and the harmless bacteria that normally live on the skin and in the vagina usually stop Candida from thriving. Candida favor warm, moist, parts of the body not exposed to air.

Risks

When the defense mechanisms are down, it gives opportunities for thrush to develop. This can happen when the patients are physically or mentally “run down”:

• Pregnant women where hormonal changes may alter the bacteria balance in the mouth and may pass the fungus to the newborn during delivery
• Those on oral contraceptive pill
• Diabetic patients where large amount of sugar inside saliva encourages the growth of Candida
• People on steroid medications
• Patients on an antibiotic course where balance of bacteria in the mouth is altered
• HIV patients
• Cancer patients whose immunity system is weakened from both disease and from treatments such as chemotherapy and radiation
• Infants are prone to thrush as their immune system is not fully developed.
• Elderly are more susceptible to thrush as they may have a weaker immune systems.
• Those with poor dental care, especially those who have false teeth

Signs & symptoms

Vaginal Thrush

• Itchiness
• Redness in the vaginal area
• Pain, especially during intercourse
• Frequency in urination accompanied by a burning sensation during urination
• White or yellow cheeselike discharge from vagina

• May cause sore throat
• White, cream-colored or yellow spots which are slightly raised in the mouth which are easily scraped off with a finger or a blunt object
• Normally no pain in the area underneath the spots
• May cause burning sensation in the mouth and the throat

• Occurs especially on skin areas that are irritated, moist, warm or airless, for instance, nappy area of a baby, armpits, groin, skinfold of the stomach, or under the breasts in women.
• Appears as bright shiny red rash, with spots and scaly patches around the edges, sometimes with softening and breakouts on skin
• Burning, itchy sores.

Self care

Baby/Child with mild thrush

• Use clean bottle nipples and pacifiers
• Keep all prepared bottles and nipples in the refrigerator to decrease the likelihood of yeast growth
• Do not reuse a bottle used for more than an hour because yeast may have grown on the nipple
• Boil all objects that the children may put in their mouth
• Breast feed your baby if possible as breast milk contains antibodies that will boost the baby’s immune system
• Change soiled diapers
• Clean your child’s mouth with a clean moist cloth regularly
• Massage plain, unflavored yogurt that contains live cultures around the inside of your child's mouth to help healthy bacteria grow in the mouth
• If your baby is taking antibiotic medication for a different infection, rinse his or her mouth out with water after each dose because antibiotic medications can disrupt the balance of bacteria in the mouth and allow growth of the yeast that causes thrush

• Practice good oral hygiene, including brushing and flossing your teeth daily and using an antiseptic mouthwash. If you have had a previous thrush infection, replace your toothbrush to help prevent another infection
• Practice good hand washing
• Get treatment for conditions that increase your risk for thrush, such as diabetes, human immunodeficiency virus (HIV), or cancer
• In people with acquired immunodeficiency syndrome (AIDS) mouthwash may be particularly helpful

Medication Oral thrush

• If sore throat exists, you may get some anti-inflammatory lozenges over the counter.
• May also gargle with anti-fungal solution e.g. nyastatin solution.

• Clean the infected area with an antifungal medication, such as nystatin (Mycostatin)
• Keep the infected area dry
• Applying lanolin-containing body lotion may help relieve the soreness

• Apply anti-fungal cream to the affected area
• A single dose of oral medication (fluconazole-Diflucan) can be effective and is used when creams do not work
• Taking probiotics may restore the balance of micro organism in the body
• An acidic gel may be helpful in restoring the correct acidity
• A warm salty bath can relieve itchiness and aid recovery