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Skin thrush pictures. Thrush in Men: Symptoms, Treatment, and Prevention of Male Candidiasis

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What are the common symptoms of thrush in men. How is male candidiasis diagnosed and treated. What preventive measures can help avoid fungal infections in males.

Understanding Male Candidiasis: Causes and Risk Factors

Thrush, also known as candidiasis, is a fungal infection caused by Candida yeasts, primarily Candida albicans. While it’s often associated with women, men can also develop this condition. Male candidiasis typically affects the genital area, particularly the head of the penis and foreskin.

Several factors can increase the risk of developing thrush in men:

  • Use of antibiotics or corticosteroids
  • Weakened immune system
  • Diabetes
  • Poor hygiene practices
  • Excessive use of cleansing products

Is thrush considered a sexually transmitted infection? While genital candidiasis is not classified as an STI, it can be transmitted during sexual intercourse. This underscores the importance of proper hygiene and treatment for both partners if one is affected.

Recognizing the Symptoms of Male Thrush

Identifying thrush in men can be challenging, as symptoms may vary or be absent altogether. However, when inflammation occurs, several signs may become apparent:

  • Itching and soreness around the penis head
  • Blotchy rash with small papules or white patches
  • Dull red skin with a glazed appearance
  • Swelling and irritation
  • Thick, white, lumpy discharge under the foreskin
  • Difficulty retracting the foreskin
  • Pain during sexual intercourse or urination

How can you differentiate thrush from other genital conditions? While these symptoms are indicative of thrush, it’s crucial to consult a healthcare professional for an accurate diagnosis, as other conditions may present similarly.

Effective Treatment Options for Male Candidiasis

Treating thrush in men often involves a combination of medication and proper hygiene practices. The choice of treatment depends on the severity of the infection and individual factors.

Antifungal Medications

Several antifungal medications are available to combat male candidiasis:

  1. Clotrimazole (Lotrimin)
  2. Econazole nitrate (Specazole)
  3. Miconazole nitrate (Monistat)
  4. Nystatin (various brand names)

These medications come in topical creams or oral forms. Topical treatments are typically applied directly to the affected area once daily for 7 to 21 days.

Are over-the-counter treatments effective for male thrush? While many antifungal medications are available without a prescription, it’s advisable for men who haven’t previously treated thrush to consult a doctor before self-medicating.

Preventive Measures and Hygiene Practices

Maintaining good hygiene is crucial in preventing and managing thrush in men. Here are some essential tips:

  • Wash the penis carefully with warm, running water
  • Avoid using perfumed shower gels or soaps on the genitals
  • Dry the penis thoroughly after washing
  • Wear loose-fitting cotton underwear to promote air circulation
  • Clean under the foreskin regularly to prevent smegma buildup

How can proper hygiene prevent recurrent thrush infections? By maintaining these hygiene practices, men can significantly reduce their risk of developing thrush and manage existing infections more effectively.

The Role of Probiotics in Managing Male Candidiasis

Probiotics have gained attention as a potential treatment for recurrent yeast infections. These beneficial bacteria, particularly Lactobacillus species, may help combat Candida overgrowth.

Recent laboratory findings published in Biofouling (2018) suggest that certain Lactobacillus species could reduce Candida cell numbers in some types of candidiasis infections. However, the effectiveness of probiotics in preventing or treating thrush remains a topic of debate among researchers.

Should men with recurrent thrush consider probiotic supplements? While probiotics show promise, more research is needed to establish their efficacy in treating male candidiasis. Men experiencing persistent or recurrent infections should consult their healthcare provider for personalized advice.

Complications and When to Seek Medical Attention

While many cases of male thrush can be managed with over-the-counter treatments and good hygiene, some situations warrant medical attention:

  • Persistent symptoms despite treatment
  • Recurrent infections
  • Severe pain or discomfort
  • Spread of the infection to other areas
  • Underlying health conditions that may complicate treatment

How can untreated thrush affect men’s health? If left untreated, thrush can lead to more severe complications, including increased risk of HIV transmission and potential spread of the infection to other parts of the body.

The Impact of Male Thrush on Sexual Health and Relationships

Thrush can significantly impact a man’s sexual health and intimate relationships. The discomfort and symptoms associated with the infection may lead to:

  • Reduced sexual desire
  • Pain or discomfort during intercourse
  • Emotional distress or embarrassment
  • Strain on intimate relationships

How can couples navigate intimacy when one partner has thrush? Open communication, mutual understanding, and temporary abstinence during treatment can help couples manage the impact of thrush on their relationship. It’s also important for both partners to be treated simultaneously to prevent reinfection.

Debunking Myths and Misconceptions About Male Thrush

Several misconceptions surround male candidiasis, which can lead to unnecessary anxiety or delayed treatment. Let’s address some common myths:

  • Myth: Only women get thrush
  • Fact: Men can also develop thrush, although it’s less common than in women
  • Myth: Thrush is always sexually transmitted
  • Fact: While it can be passed during intercourse, thrush is not classified as an STI
  • Myth: Poor hygiene always causes thrush
  • Fact: While hygiene plays a role, other factors like antibiotics and immune system issues can also contribute

Why is it important to dispel these myths about male thrush? Accurate information helps men recognize symptoms early, seek appropriate treatment, and take effective preventive measures.

In conclusion, male candidiasis is a manageable condition that can be effectively treated with proper medical care and good hygiene practices. By understanding the causes, symptoms, and treatment options, men can take proactive steps to maintain their genital health and overall well-being. Remember, when in doubt, it’s always best to consult a healthcare professional for personalized advice and treatment.

Thrush in men (male candidiasis): Symptoms and treatment

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Thrush is a fungal infection caused by Candida yeasts, and especially Candida albicans. It often affects women, but it can occur in men, too.

Other names for thrush include yeast infection, Candida, candidiasis, candidal balanitis, and formerly, moniliasis.

When thrush occurs in males, it can affect the head of the penis and the foreskin. It can lead to inflammation of the head of the penis, known as balanitis.

Oral thrush affects the mucous membranes, for example, of the mouth.

Fast facts on thrush in men

  • Candida normally lives on the skin and mucous membranes, but if too much grows, it can cause symptoms.
  • Symptoms include an itchy rash, red skin, swelling, irritation, and itching around the head of the penis, lumpy discharge under the foreskin, or pain when urinating and during sex.
  • Risk factors include the use of antibiotics or corticosteroids, immunosuppression, diabetes, poor hygiene, and using too many cleansing products.
  • Genital candidiasis is not considered a sexually transmitted infection (STI), but transmission can occur during vaginal intercourse.
  • Oral or local antifungal treatments can be used to treat candidiasis.
  • Good hygiene practices can help prevent it.

Was this helpful?

In men, thrush affects the head of the penis and, if present, the foreskin.

It can also occur on other areas of skin or mucous membrane, for example, in the mouth. This is known as oral thrush.

There are often no symptoms, but if inflammation occurs, the following symptoms may appear around the head of the penis:

  • itching and soreness
  • a blotchy rash with small papules or white patches
  • dull red skin with a glazed appearance
  • swelling and irritation

There may also be:

  • a thick, white, lumpy discharge under the foreskin or in the skin folds, possibly with an unpleasant odor
  • difficulty pulling back the foreskin

Pain may be present during sex or when passing urine.

Many mild infections do not require treatment. Some medications are available, and there are also home remedies that may help.

Antifungal topical creams or oral medication may help to relieve symptoms. They are equally effective. Both topicaland oral forms are available from a doctor, over-the-counter at a pharmacy, or online.

According to the Centers for Disease Control and Prevention (CDC), a doctor may prescribe the following drugs:

  • Clotrimazole (Lotrimin)
  • Econazole nitrate (Specazole)
  • Miconazole nitrate (Monistat)

People apply creams topically, directly onto the affected area, usually once a day for 7 to 21 days.

Nystatin is another topical antifungal. It has numerous brand names, but it is less effective than the topical imidazoles.

Clotrimazole, miconazole, and various topical preparations for preventing and treating fungal infections are available for purchase online.

A man who has not had treatment for thrush previously should see a doctor before treating themselves.

Good hygiene prevents thrush and helps to treat it.

Share on PinterestHygiene is important for preventing infections, but avoid perfumed shower products, as they can make symptoms worse.

Tips for good hygiene include:

  • washing the penis carefully with warm, running water
  • not using perfumed shower gels or soaps on the genitals, because they can cause irritation
  • drying the penis carefully after washing
  • wearing loose-fitting cotton underpants to help keep the genital area dry and cool

In men with a foreskin, poor hygiene underneath it can lead to the build-up of a cheesy-looking substance called smegma. Smegma can cause irritation.

Do probiotics work?

People who get recurrent yeast infections often try probiotics and other alternative treatments containing Lactobacillus bacteria.

There is conflicting evidence about its effectiveness, but laboratory findings published in Biofouling in 2018 suggest that some species of Lactobacillus may reduce the number of Candida cells in some types of candidiasis infection.

However, there is no evidence to suggest that probiotics contribute in any way to the prevention or treatment of Candida infections in men.

Supplements and other products that may help relieve thrush are available for purchase online.

Complications

In rare cases, a man with weakened immunity who has genital thrush may develop invasive candidiasis. This is a fungal infection of the blood, and it can cause the fungus to spread throughout the body.

In this way, it can affect different organs in the body, including the brain, the liver, and the heart.

An infection that affects the whole body is systemic. A systemic fungal infection can be fatal, according to the United States National Institutes of Health. and it is a medical emergency.

Emergency treatment in hospital protects organs from the infection while antifungal drugs are administered to kill it.

Sometimes, if a man with weakened immunity develops thrush, he may need to go to the hospital as a precaution.

Factors that increase this risk include:

  • having an HIV infection
  • having diabetes
  • using immunosuppressant drugs
  • undergoing high-dose chemotherapy or radiotherapy treatment for cancer
  • having a central venous catheter (CVC) for medication
  • being on dialysis

Candidiasis is caused by a yeast fungus, Candida.

Candida fungi occur naturally inside the body and on the skin, but at levels that do not cause problems. The immune system keeps them in check.

However, if certain conditions disturb the balance, the fungus can thrive, and candidiasis can develop. The fungal cells produce hyphae, structures that penetrate the tissue.

Risk factors that make candidiasis more likely include:

  • use of broad-spectrum antibiotics, which can upset the balance of normal microbial flora and allow the Candida to overgrow
  • taking medications that suppress the immune system, such as chemotherapy or corticosteroids
  • having a weakened immune system, due, for example, to HIV or dialysis
  • poorly-managed type-1 or type-2 diabetes, because yeasts thrive more easily in higher levels of blood sugar
  • obesity, especially if there are rolls of fat where yeast can thrive
  • poor hygiene, especially if a man is not circumcised
  • bath foam, soaps, shower gels, lubricants, and other products, which can irritate and damage the skin of the penis, leaving it open to infection
  • not drying carefully after washing, because the fungus can thrive in warm, moist conditions
  • having a poor diet

Studies show that men who are not circumcised are more likely to develop Candida balanitis.

Is it sexually transmitted?

Doctors do not consider genital candidiasis as a sexually transmitted infection (STI). People usually acquire it through sexual activity, but it can develop without sexual contact. A partner with a fungal infection does not always transmit it.

However, people should avoid unprotected sex with a partner who has thrush until treatment has cleared up the infection.

Thrush may disappear without treatment. However, if it does not go away, and if treatment does not remove the infection, it is important to see a doctor to rule out other possible problems, such as diabetes, which can make infection more likely.

Screening for STIs may be appropriate.

If the rash is severe or if the doctor is unsure of the diagnosis or suspects an underlying cause, they may send a swab from around glans penis and under the foreskin to the lab for testing.

If there are persistent sores or ulcers that do not heal, a biopsy may be necessary.

Candidiasis can affect men, as well as women. In men, it can lead to a condition known as balanitis.

Often there are no symptoms, or symptoms are mild, and over-the-counter treatment will relieve them. However, if symptoms persist, the person should see a doctor.

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Continuing Education Activity

Candidiasis is an opportunistic infection due to Candida, which can affect the oral cavity, vagina, penis, or other parts of the body. Untreated Candida infection carries the risk of leading to a systemic infection in which other organs can become involved and may lead to sepsis. This activity covers the presentation, examination, diagnosis, treatment, and management of this condition to enable healthcare practitioners to achieve optimal patient outcomes.

Objectives:

  • Identify the etiology of candidiasis medical conditions and emergencies.

  • Review the steps involved in the evaluation of candidiasis.

  • Outline the management options available for candidiasis.

  • Discuss interprofessional team strategies for improving care coordination and communication to advance candidiasis and improve outcomes.

Access free multiple choice questions on this topic.

Introduction

Candidiasis is an opportunistic infection caused by Candida, a type of fungi. Fungi are eukaryotic organisms found in the form of yeasts, molds, or dimorphic fungi. Candida is a form of yeast. Candidiasis occurs most commonly as a secondary infection in immunocompromised individuals. Synonyms of candidiasis include candidosis, moniliasis, and thrush. These are common inhabitants in the oral cavity, gastrointestinal tract, vagina penis, or other parts. They become pathogenic only when favorable conditions arise.  It can affect the oral cavity, vagina, penis, or other parts of the body. Candidiasis affecting the mouth is commonly called thrush. It presents as white patches on the tongue, throat, and other mouth areas. Soreness and difficulty in swallowing include other symptoms associated with thrush. The vagina, when affected with Candida, is called a yeast infection.[1] 

Oral candidiasis can be pseudomembranous, erythematous, and chronic hyperplastic candidiasis. Pseudomembranous candidiasis is common in chronically ill patients and infants. It is presented as white, soft, slightly elevated plaques most commonly on the tongue and buccal mucosa. Plaques resemble curd and consist of tangled masses of fungal hyphae with intermingled desquamated epithelium, necrotic debris, keratin, leukocyte, fibrin, and bacteria. This white plaque, when wiped away, leaves an erythematous area.

Erythematous candidiasis is also known as antibiotic sore mouth. It occurs as a sequel to the use of broad-spectrum antibiotics or corticosteroids. The lesions present as consistently painful erythematous areas along with central papillary atrophy of the tongue. It is also known as a kissing lesion when the palate is involved and exhibits erythema due to contact with the tongue.  

Chronic hyperplastic candidiasis, also known as candidal leukoplakia, presents with firm white persistent plaques on lips, tongue, and buccal mucosa. These plaques may be homogenous or nodular and persist for years. It has premalignant potential.

Candida associated lesions include denture stomatitis, angular cheilitis, and median rhomboid glossitis. Secondary oral candidiasis can also occur, which include chronic mucocutaneous candidiasis, chronic familial candidiasis, chronic localized mucocutaneous candidiasis, chronic diffuse mucocutaneous candidiasis, and candidiasis endocrinopathy syndrome.

Vaginal candidiasis presents with genital itching, burning, and a white “cottage cheese-like” discharge from the vagina. The penis is less commonly affected by a yeast infection and may present with an itchy rash. Yeast infections may spread to other parts of the body resulting in fevers along with other symptoms and become invasive rarely. 

Oral candidiasis is one of the most common fungal infections, affecting the oral mucosa. The yeast Candida albicans cause these lesions. Candida albicans are among the components of normal oral microflora, and around 30% to 50% of people carry this organism. The rate of carriage increases with the age of the patient. Candida albicans are recovered from 60% of dentate patients’ mouths over the age of 60 years.

There are many forms of Candida species, which present in the oral cavity. Species of oral Candida include C. albicans, C. glabrata, C. krusei, C. parapsilosis, C. pseudotropicalis, C. stellatoidea, and C. tropicalis. Oral candidiasis may present as a variety of disease entities in both normal hosts and the immunocompromised. These include hyperplastic or atrophic (denture) candidiasis, pseudomembranous candidiasis (thrush), linear gingival erythema, median rhomboid glossitis, and angular cheilitis. It can result in a broad range of clinical manifestations ranging from mild acute superficial infections to fatal disseminated disease. Disseminated candidiasis is almost exclusively in acquired or inherited immuno-deficiencies. Superficial candidiasis is the most common form. 

Etiology

Candidiasis is an opportunistic infection. Candida albicans is present in healthy persons colonizing the oropharyngeal, esophageal, and gastrointestinal mucosa. Candida albicans can cause mucosal candidiasis in these areas where they usually are present in an immunocompromised host. In patients who have leukemia, lymphoma because of the consumption of corticosteroids or cytotoxic drugs, their immunity is compromised, leading to candidal infection.

Antibiotic usage is commonly associated with candidiasis. Cancer cytotoxic chemotherapy may result in fungemia caused by Candida albicans, which develop from fungal translocation through compromised mucosal barriers. Fungal commensals in the upper and lower GI tract can transform into opportunistic pathogens due to changes in endogenous bacterial population size or composition, as well as changes in the host environment. [2] Vaginal colonization increases in diabetes mellitus, pregnancy, and the use of oral contraceptives. Oral candidiasis is very closely associated with HIV patients. More than 90% of patients with HIV present with candidiasis.

Other predisposing factors of candidiasis include TB, myxedema, hypoparathyroidism, Addison’s disease, nutritional deficiency(vitamin A, B6, Iron), smoking, poorly maintained dentures, IV tubes, catheters, heart valves, old age, infancy, and pregnancy. Xerostomia is also a predisposing factor due to the absence of protective antifungal proteins, histatin, and calprotectin.

Epidemiology

Candidiasis is more prevalent in old age and infancy. In the US, about 37% of newly born babies may be affected by thrush during the first few months of life. Children using inhaled steroids also have a higher incidence of oral candidiasis. In women, it is common during pregnancy. Thrush may be the first indication of HIV infection. Thrush is universal and is more frequent in populations with poorly nourishment. Thrush occurs equally in males and females.

Although Candida albicans is the most prevalent etiology of candidiasis, there has been a significant increase in non-Candida species in recent times. It is important to know about non-albicans species as the treatment depends on that, and certain medications like commonly used Non-albicans Candida may be resistant to fluconazole. Among the Candida species, C. albicans was the most common species (42/95; 44.21%), followed by C. lusitaniae (18/95; 18.95%), C. parapsilosis (13/95; 13.69%), C. glabrata (8/95; 8.42%), C. kefyr (6/95; 6.31%), C. famata (5/95; 5.26%), C. africana (2/95; 2.11%), and C. orthopsilosis (1/95; 1.05%), respectively.[3] The incidence of invasive and disseminative candidiasis has been on the rise globally, and people with an impaired immune system are the most vulnerable.[4]

Pathophysiology

Candida albicans cause thrush when normal host immunity is disturbed. The organism may overgrow on the oral mucosa causing desquamation of epithelial cells and accumulation of keratin, bacteria,  and necrotic tissue. This debris form a pseudo-membrane, which adheres closely to the mucosa. This membrane may rarely involve extensive areas of edema, ulceration, and necrosis of underlying mucosa.

Neonates affected with thrush are usually colonized by C. albicans during passage through the affected vagina; with an active vaginal yeast infection, the chances of development of thrush in the neonate increase. 

There are three major routes by which Candida reaches the bloodstream: the most frequent route is via the gastrointestinal tract mucosal barrier, others being through an intravascular catheter and from a localized infection. Candida can pass into the bloodstream in neutropenic patients as well as in intensive care unit patients. They are also a part of the normal gut microflora, and any condition that may make a person immunocompromised can lead to candidiasis in the bloodstream. Candida growth of indwelling catheters, especially central lines, can occur at either the implantation site or the hub and lead to the next infection with Candida. Bloodstream invasion is not common from a localized infection but frequent with ascending Candida urinary tract infection associated with either intrinsic obstruction or extrinsic compression.

Vulvovaginal candidiasis may be triggered by the use of local or systemic antimicrobial therapy, and it may also precipitate recurrent episodes of disease. The exact mechanism by which antibiotics cause candidal vulvovaginitis is still unknown. Hypothetically, the pathophysiology of vulvovaginitis may be due to reduction or change of normal vaginal flora, restraints of yeast colonization, and proliferation.[5]

Histopathology

Candidiasis sections present spongiotic changes in the epidermis with irregular acanthosis, mild spongiosis, and inflammatory changes. The distinguishing feature of the superficial epidermis is the presence of neutrophils in the stratum corneum and upper layers of the epidermis. A small collection of neutrophils (spongiform pustulation) may form, which resembles impetigo or psoriasis.[6] 

Candida albicans is a pathogenic yeast-like fungus, that grows partly as yeast and partly as elongated cells resembling hyphae which form pseudo mycelium. Candida albicans can be identified from other candida species by growth characteristics, sugar assimilation, and fermentation tests. It produces germ tubes within two hours when incubated in human serum at 37-degree celsius.

History and Physical

The patient with vulvovaginitis may present with intense itching and irritation in the vagina and vulva, a burning sensation with urination which can be mistaken for urinary tract infection, vaginal soreness, or pain, a dry erythematous rash, and a thick white cottage cheese-like discharge.

Candida also presents as an oral infection called thrush, which is a white or yellow non-scrapable rash on the tongue and mucous membranes of the mouth, or redness and soreness with cracking at the corners of the mouth. It causes pain with swallowing when it extends into the oral pharynx. It is common in infants, the elderly, and patients with a compromised immune system. Systemic candidemia causes fever, chills, hypotension, and confusion.

Laryngeal Candida infection is a rare condition. It predominantly presents in females. They usually complain of dysphonia. It largely correlates with gastroesophageal reflux or a history of usage of inhaled corticosteroids. Glottis may be affected by the presence of leukoplastic lesions.[7]

Evaluation

A vaginal discharge sample can help to diagnose vaginal candidiasis by examining it under a microscope or by fungal culture in a laboratory. Under the microscope, budding yeast is visible. Oral thrush is mostly a clinical diagnosis but can also be confirmed by looking at the scrapings of the rash under the microscope. For systemic candidiasis, a blood culture is a diagnostic tool.[7]

Treatment / Management

Candida infections are treated with antifungal medications such as nystatin, clotrimazole, amphotericin B, miconazole. Mild or moderate genital Candida infections can have treatment with antifungal vaginal cream. The antifungal creams come in 1, 3, or 7-day treatment. Econazole or fluconazole 150 mg orally one-time dose can also be prescribed.[8] 

Oral and topical treatments have similar efficacy, but oral medications are more expensive. Clinicians should avoid prescribing fluconazole in the first trimester of pregnancy.[9] For recurrent vaginal candida infections, fluconazole dosing is on days 1, 4, and 7, and then weekly for six months is given. Similar treatment can be used for oral thrush, with oral lozenges as a substitute dose form. Systemic candidiasis requires treatment with oral or intravenous antifungal medications, including caspofungin, fluconazole, and amphotericin B.

In cases of denture stomatitis, the patient should refrain from using their denture for at least two weeks along with the topical application of antifungal medication. Angular cheilitis occurs due to loss of vertical dimension. Thus, after the infection subsides fabrication of new denture prostheses with proper vertical dimensions is essential. Oral application of probiotics can serve as an adjuvant in treating oral candidiasis.[10]

Differential Diagnosis

Spongiform pustulation can also present in pustular psoriasis, subcorneal pustulosis, acute generalized subcorneal pustulosis conditions. Hence, special stains should be used to exclude fungal etiology in psoriasis.

Impetigo also shows spongiform pustulation. Bacterial colonies in impetigo may be seen by using Gram stain, which GMS and PAS stains will not stain fungal forms.

Spongiform pustulation is a characteristic of tinea cruris and corporis. Special stains reveal septate hyphae without the budding yeasts of candida. The distinction can occasionally be challenging. Candida usually infiltrates the keratinized epithelium, whereas dermatophytosis usually involves only the stratum corneum.

The correct diagnosis of laryngeal candidiasis is difficult for the otolaryngologist, and a high level of suspicion is in order. This condition should also be part of the differential diagnosis in patients with predisposing factors presenting with suspected lesions.[7]

Prognosis

Vaginal and skin infections, although the most common Candida infections are localized. Therefore these can be treated with antifungal drugs to obtain complete recovery and excellent prognosis and outcomes. An untreated Candida infection can affect other organs and may lead to a systemic infection. The long-term prognosis with systemic candidiasis depends on the severity and location of the Candida infection, the general health of the infected person, and the timing of diagnosis and treatment. 

Almost one-third of the patients with candidemia develop septic shock according to host factors such as age and source of the infection than intrinsic virulence factors of organisms.[11]

Complications

Pregnant women have higher chances of colonizing Candida in the vagina during pregnancy,[12] Vaginal candidiasis is among the common forms of fungal diseases frequently occurring in pregnant women which may lead to systemic infections in neonates, especially with low birth weight (LBW) and prematurity after delivery.

Intertrigo is a common inflammatory dermatosis affecting opposing skin surfaces that can result from Candida, under the effect of mechanical and environmental factors. It presents with pain and itching, which decreases the quality of life, leading to high morbidity. Predisposing factors, such as obesity, diabetes mellitus, and immunosuppressive conditions, facilitate both the incidence and recurrence of the disease. candidal intertrigo is usually treated with topical application of nystatin and azole group antifungals.[13]

Untreated Candida infection carries the risk of leading to a systemic infection in which other organs can become involved and may lead to sepsis. Intestinal candidiasis can occur as a sequel to oral antibiotic therapy. Bronchopulmonary candidiasis is a rare complication of pre-existing pulmonary disease. Septicemia, endocarditis, and meningitis occur as terminal complications in immunosuppressive and leukemic patients. In leukemia patients, systemic candidiasis presents as prolonged neutropenia and fever refractory to the antibiotic.

Deterrence and Patient Education

Symptoms of a yeast infection may mimic other conditions. Hence physical examination and laboratory testing are very important. The risk factors that may increase the chances of developing a yeast infection include antibiotic usage, diabetes mellitus, pregnancy, hormonal birth control, and immunocompromised conditions such as  HIV, chemotherapy, or some medications. It is essential to test and diagnose accurately when symptoms are bothersome and before starting any treatment. 

Enhancing Healthcare Team Outcomes

A primary care physician can easily diagnose candidiasis, but it can pose a problem when it recurs or is present in immunocompromised individuals. For the care of such individuals, it is important to have the help of the pharmacist who will be vital in guiding the treatment of resistant or recurrent infections. Obstetrics/gynecology may also be helpful in pregnant females along with nurses who can educate them on lifestyle modification.

Oral candidiasis usually occurs beneath denture-bearing areas. Thus diagnosis and treatment of oral candidiasis are often done by the dentist. Proper oral hygiene instructions should be given to denture patients to prevent the development of oral candidiasis. The dentist should consult with the physician to find out any underlying immunocompromising situation. Nanomaterial incorporated dentures can be given to patients who are susceptible to oral candidiasis.[14]

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References

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Disclosure: Arya R declares no relevant financial relationships with ineligible companies.

Disclosure: Naureen Rafiq declares no relevant financial relationships with ineligible companies.

Thrush (candidiasis) in the mouth – treatment, types and causes of the disease

Table of contents

    Oral candidiasis refers to inflammatory diseases. It can develop due to damage to the mucosa. Thrush in the mouth in adults and children is formed due to the defeat of the Candida fungus. Doctors often associate this disease with a decrease in immunity. According to recent studies, about 90% of the population are carriers of this fungus. Most often, the presence of this fungus does not manifest itself.

    Causes of candidiasis

    Oral candidiasis can be a sign that there are big problems in the body. In order for the fungus to actively multiply, special conditions are required. As a rule, those who ignore oral hygiene face candidiasis in the mouth. Increase the risk of caries, gum disease. All this in combination has a detrimental effect on the protective barrier of our body.

    Another list of causes is the presence of the following diseases:

    • human immunodeficiency virus;
    • diabetes mellitus;
    • the presence of malignant tumors;
    • vitamin deficiency;
    • dystrophy;
    • severe infectious diseases;
    • recent surgery.

    There are also specific reasons for the development of candidiasis. For example, thrush can form after long-term antibiotic treatment. The use of such strong medicines adversely affects not only the harmful microflora, but is also capable of killing the beneficial one. This causes an imbalance and promotes the reproduction of the fungus.

    Also, the disease can develop after inhalation with corticosteroids. In this case, ulcers will appear in those places where there was contact with medicines. Affects the reproduction of the fungus and the diet. Consumption of large amounts of carbohydrates causes Candida activity.

    Increase the risk of thrush and bad habits. In particular, smoking. Acute pseudomembranous candidiasis is common in people with tongue piercings.

    Among the risks is the presence of bridges. However, there is a risk only if the patient does not comply with hygiene standards. Therefore, it is important to carefully disinfect as a preventive measure against candidiasis. In addition, do not forget to remove the prosthesis at night. Otherwise, the disease will progress very actively. Also, during sleep, the prosthesis can provoke microdamages, which affects not only the mucosa, but also the state of the enamel.

    Quite often, candidiasis can be caused by drying out of the mucosa. Often this factor is accompanied by other diseases. Therefore, it is important to consider all the symptoms.

    Oral candidiasis is much more common in children than in adults. Doctors explain this by the fact that the child has not yet fully formed immunity. Therefore, bacteria enter the baby’s body during childbirth.

    Types of oral candidiasis and symptoms

    Depending on the individual case, symptoms may vary. This is also affected by the level of damage to the mucous membranes. There are several forms of the disease:

    • acute pseudomembranous;
    • acute atrophic;
    • atrophic in the chronic stage;
    • hyperplastic in the chronic stage.

    Despite the different symptoms, the treatment for all forms is almost identical.

    Acute pseudomembranous candidiasis

    This form often occurs without any special symptoms. The patient only feels a slight discomfort associated with the appearance of a light film on the mucosa. If the disease proceeds easily, the film lags behind the mucosa without effort. In this case, the part under the film is painted in a bright pink hue. If the disease is severe, the plaques will be larger. Most often, the severe course of the disease occurs in infants. Less common in adults after taking antibiotics or corticosteroids.

    Acute and chronic atrophic candidiasis

    A vivid symptom of the acute form is too active burning. In this case, a light coating may not even form. Most patients report a metallic taste in their mouth. There may also be a salty or bitter taste. Many patients with this form of candidiasis call dryness of the oral mucosa a separate symptom. Most often, this form provokes the intake of appropriate medications.

    Chronic atrophic candidiasis is characterized by less pronounced redness and itching. The most common cause of the development of the disease is the installation of prostheses.

    Chronic hyperplastic candidiasis

    Chronic hyperplastic candidiasis mainly occurs in adult patients. The spread of the fungus can go even to the corners of the mouth, affects the lips, soft palate. The resulting ulcers and plaques begin to merge together. With the course of the disease, they become covered with a rough crust, acquire a yellow tint.

    Methods of diagnosis

    Oral thrush in adults can be treated by a dentist. Initially, it is necessary to conduct an examination, collect an anamnesis. The specialist will note what medications you took, whether there are diseases in a chronic form. Be sure to take an analysis of the plaque for research. Often, non-fungal elements can be confused with fungal ones.

    It is important to properly prepare for sampling. Scraping is taken in the morning on an empty stomach. Do not brush your teeth or rinse your mouth with mouthwash before the procedure. The day before the test, it is worth reducing food with a large amount of carbohydrates. This will reduce the risk of developing pathogenic flora. Thanks to a qualitative study, you can not only establish whether the disease is really caused by the Candida fungus, but also find out how sensitive the flora is to certain medications. Depending on the results of this analysis, the specialist prescribes the appropriate therapy.

    Features of treatment

    The attending physicians prescribe local antifungal medicines as the basis for therapy. Today, there are many of them in the pharmaceutical segment, but the indicator of drug resistance of fungi also changes every year. Today, for example, Candida has almost complete resistance to Fluconazole, although earlier this drug was used most actively.

    Depending on the clinical picture, it is important to select the treatment on an individual basis. The scheme can be influenced by the type of pathogen, personal characteristics, previously collected anamnesis.

    Topical medications must be included in the treatment regimen as an aid. These include:

    • mouth rinses;
    • drug in the form of gels, suspensions;
    • lozenges, special lozenges;
    • irrigation solutions or sprays;
    • ointment for topical application and tamponade.

    The attending physician may prescribe specialized antiseptics, prescribe the use of saline solutions for irrigating the mouth. As a rule, among antiseptics, formulations with iodine, chlorhexidine, gentian violet are most often used. In some cases, the use of lozenges or lozenges works effectively.

    Conditions for effective treatment

    In order to effectively cure thrush, it is necessary to understand the cause of its occurrence. If the cause of the disease is poor oral hygiene, it is worth treating the gums, teeth, and eliminating caries. All these nuances can be considered as potential foci of inflammation. Therefore, having treated the entire dentition together with thrush, you can reduce the duration of treatment. It is also recommended to undergo a cleaning procedure from tartar – often it injures the mucous membrane with its sharp corners.

    Given that removable dentures may be the cause, it is important to repeat the consultation with the patient, reminding him of hygiene procedures. If the period of use of the prosthesis comes to an end, it is worth replacing it. Otherwise, it will become a breeding ground for Candida.

    Any crowns that have deteriorated must also be replaced. Repair any chips on the enamel surface. They can injure the gums and cause the spread of bacteria.

    During treatment, smokers are advised to refrain from addiction. In the event that the disease was caused by taking corticosteroids, it is necessary to reconsider the treatment regimen. After using aerosols with the drug, it is important to rinse your mouth thoroughly with plenty of water.

    When undergoing treatment, if the cause of the disease is taking antibiotics, it is necessary to add medicines to the therapy regimen to restore the balance of microflora. In this regard, the patient may need additional advice from a highly specialized specialist. The intake of probiotics and prebiotics is selected on an individual basis.

    For all people undergoing therapy for thrush in the mouth, there is a list of recommendations:

    • strictly follow all the rules of oral hygiene;
    • limit intake of carbohydrate foods;
    • give up sweets.

    All food that is capable of irritating the mucous should be excluded from the patient’s diet. These are dishes that contain vinegar, a lot of spices and spices, smoked foods, fruits with high acidity. In addition, it is forbidden to consume yeast baked goods, sugar. The temperature of the food should be warm. Even after completing the course of therapy, it is necessary to follow such restrictions for about 2 months.

    In some cases, your healthcare professional may recommend additional use of toothpastes with glucose oxidase or other ingredients. They form a protective mucosal barrier in the mouth. Also, such pastes are often included in preventive treatment. The paste is selected individually depending on the results of the analysis. In the same way, a toothbrush is selected.

    Candidiasis prophylaxis

    There is a specific Candida prophylaxis that is given to HIV-positive patients. The same prophylaxis is required when the patient is undergoing radiation therapy or a course of antibiotics. In the event that there are no such risk factors, the treating specialist will provide separate recommendations.

    When carrying out prophylaxis for diabetics, patients with chronic lung diseases, it is important to control the course of the underlying disease. It is necessary to visit the attending physician in a timely manner and take a course of prescribed medications.

    If it is impossible to do without antibiotics during the treatment of another disease, it is worth considering the main recommendations:

    • antibiotic therapy should be prescribed exclusively by a doctor;
    • the duration of the course is calculated by the attending specialist, you can not violate the regimen;
    • If it is necessary to prescribe a longer course or repeat antibiotics, the patient should additionally be given appropriate antifungal therapy as a preventive measure.

    If the patient also needs to treat asthma in the chronic stage, it is necessary to discuss with the attending physician the possibility of using a nebulizer. After inhalation is carried out, it is important to rinse your mouth with water. Otherwise, there is a risk of a negative effect of drugs on the oral mucosa.

    In case of frequent relapses of the disease, it is necessary to undergo a comprehensive examination of the whole organism. The attending physician will help to choose personal methods for diagnostics for a particular case. Often, the appearance of a fungus on the mucosa is a symptom of a serious illness.

    Article author

    Aslanova Anzhelika Andreevna

    Competent specialist in his field, high-quality approach to all types of therapeutic reception. The doctor conducts a children’s appointment, successfully adapts small patients to dental treatment, so they always leave satisfied and happy.

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