Candida Infection: Thrush

Thrush is a fungal infection in the mouth and throat. Thrush does not usually affect healthy adults. It is more common in people with a weak immune system. It is also more likely if you take antibiotics. Thrush is normally not contagious.

Understanding fungus in the mouth and throat

Your mouth and throat normally contain millions of tiny organisms. These include bacteria and yeasts. Many of these do not cause any problems. In fact, they may help fight disease.

Yeasts are a type of fungus. A type of yeast called Candida normally lives on the membranes of your mouth and throat. Usually, this yeast grows only in small amounts and is harmless. But in some cases, Candida can grow out of control and cause thrush. Thrush is related to other kinds of Candida infections that can grow all over the body. Thrush refers to an infection of only the mouth and throat.

What causes thrush?

Thrush happens when something lets too much Candida grow inside your mouth and throat. Certain things that change the normal balance of organisms in the mouth can lead to thrush. One example is antibiotic medicine. This medicine may kill some of the normal bacteria in your mouth. Candida can then grow freely. People on antibiotics have an increased risk for thrush.

You have a higher risk for thrush if you:

  • Wear dentures

  • Are getting chemotherapy

  • Are getting radiation therapy

  • Have diabetes

  • Have a transplanted organ

  • Use corticosteroids, including inhaled corticosteroids for lung disease

  • Have a weak immune system, such as from AIDS

  • Are an older adult

Symptoms of thrush

Symptoms of thrush can include:

  • A dry, cottony feeling in your mouth

  • Cracking at the corners of the mouth

  • Loss of taste

  • Pain while eating or swallowing

  • White patches on the tongue and around the sides of the mouth

Diagnosing thrush

Your healthcare provider will ask about your medical history and your symptoms. He or she will look closely at your mouth and throat. White or red patches will be scraped with a tongue depressor. The sample will be sent to a lab to test. This test can usually confirm thrush.

If you have thrush, you may also have esophageal candidiasis. This is common in people who have HIV or a weak immune system. Your healthcare provider may check for this condition with an upper endoscopy. This is a procedure to look at the esophagus. A tissue sample may be taken to test.

Treatment for thrush

Thrush is usually treated with antifungal medicine. The medicine is put directly in your mouth and throat. You may be given a “swish and swallow” medicine or an antifungal lozenge.

In some cases, you may need an antifungal pill. This can remove Candida throughout your body. Or you may need medicine through an intravenous line ( IV). These treatments depend on how severe your infection is, and what other health conditions you have.

If you are at high risk for thrush, you may need to keep taking oral antifungal medicine. This is to help prevent thrush in the future.

What happens if you don’t get treated for thrush?

If untreated, the Candida may spread throughout your body. They may even enter your bloodstream. This can cause serious problems, such as organ failure and even death. Bloodstream infection may need to be treated with high doses of antifungal medicine through an IV.

Systemic infection is much more likely in people who are very ill. It is also more common in those who have serious problems with their immune system. Additional risk factors for systemic infection in very ill people include:

  • Central venous lines

  • IV nutrition

  • Use of broad-spectrum antibiotics

  • Kidney failure

  • Recent surgery

Preventing thrush

You may be able to help prevent some cases of thrush. Make sure to:

  • Practice good oral hygiene. Try using a chlorhexidine mouthwash.

  • Clean your dentures regularly as instructed. Make sure they fit you correctly.

  • After using a corticosteroid inhaler, rinse out your mouth with water or mouthwash.

  • Do not use broad-spectrum antibiotics, if possible.

  • Get treated for health problems that increase your risk for thrush, such as diabetes.


When to call the healthcare provider

Call your healthcare provider right away if you have any of these:

  • Cottony feeling in your mouth

  • Loss of taste

  • Pain while eating or swallowing

  • White patches or plaques on your tongue or inside your mouth