Chart of opportunistic infections

October 2001     View PDF     En español

Candidiasis (thrush)

Candidiasis is a fungal infection that can infect the whole body but often occurs in the mouth and vagina.

Symptoms
White patches on gums, tongue or lining of mouth, pain, difficulty in swallowing and loss of appetite. Can also cause vaginal irritation, itching, burning and thick white discharge.

Diagnosis
Usually by visual exam, smear or culture from biopsy.

Preventive Therapy (prophylaxis)
Not currently recommended because current drugs effectively treat the disease, resistant Candida may develop and drug interactions may occur. However, studies show that continuous fluconazole use lowers the risk of developing Candidiasis. Pregnant women should not use preventive therapies, particularly azole drugs due to the risk of birth defects. Some dietary changes may help decrease risk or recurrence.

Treatment
Mild oral and vaginal Candidiasis may be treated with topical therapy like nystatin and clotrimazole. Moderate oral, vaginal and esophageal Candidiasis should be treated with pill forms of therapy such as fluconazole, itraconazole or ketoconazole which treat through the body (systemically).

Alternatives: IV amphotericin B or amphotericin B oral solution usually reserved for fluconazole resistant Candida.

Maintenance Therapy
Not currently recommended for oral or vaginal Candidiasis for the same reasons as prophylaxis. If Candida recurs frequently and/or severely, then fluconazole or itraconazole should be considered. People with frequent recurrences of esophageal Candidiasis should consider fluconazole (100–200mg a day). Pregnant women should avoid azole drugs due to risk of birth defects.

For more information, read Project Inform’s publications, Oral Candidiasis, Systemic Candidiasis or Vaginal Candidiasis.