RT Book, Section
A1 Jauch, Edward C.
A1 Valdez, J. Amadeo
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181040697
T1 Thrush (Oral Candidiasis)
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181040697
RD 2024/04/25
AB White,  flaky,  curd-like  plaques  covering  the  tongue  and  buccal  mucosa  with  an  erythematous  base  are  typical  of  thrush.  These  lesions  tend  to  be  painless,  although  some  patients  experience  a  burning  sensation.  Painful  inflammatory  erosions  or  ulcers  may  be  noted,  particularly  in  adults.  Predisposing  factors  include  antibiotic  use,  inhaled  and  oral  corticosteroids,  radiation  to  the  head  and  neck,  extremes  of  ages,  patients  with  immunologic  deficiencies,  and  chronic  irritation  (eg,  denture  use  and  xerostomia).  Colonization  of  surface  epithelium  by  Candida  occurs  due  to  altered  oral  microflora.  Hairy  leukoplakia,  lingual  lichen  planus,  flecks  of  milk  or  food  debris,  and  liquid  antacid  adhering  to  the  tongue  may  be  confused  with  candidiasis.  Hairy  leukoplakia  cannot  be  removed  with  a  tongue  depressor  (note  Fig.  20.4).  This  helps  differentiate  this  process  from  thrush  or  residue  from  ingested  materials.  Microscopic  examination  of  the  removed  specimen  for  the  presence  of  hyphae  in  potassium  hydroxide  mount  will  aid  in  the  identification  of  Candida.