Thrush (oral candidiasis) is a condition caused by Candida albicans infection, characterized by the formation of white plaques on the surface of oral mucosa. It is most commonly seen in newborns and young infants. Children with malnutrition, diarrhea, or those who have been on prolonged use of broad-spectrum antibiotics or corticosteroids are more susceptible to this condition. In newborns, infection often occurs through the birth canal or through contaminated nipples and feeding utensils during breastfeeding.
Clinical Manifestations
The surface of the oral mucosa is covered with small white curd-like spots or patches, which may gradually merge into larger plaques. These lesions are not easily wiped off, show no signs of inflammation in the surrounding area, and forcibly removing them may leave the underlying mucosa red, rough, and prone to bleeding. Thrush is typically painless, does not cause excessive drooling, and generally does not interfere with feeding. There are no systemic symptoms in most cases. Severe cases may involve widespread white plaques covering the entire oral cavity and extending to the throat, larynx, esophagus, trachea, and lungs, potentially becoming life-threatening. Severely affected children might exhibit low-grade fever, refusal to eat, and swallowing difficulties. The use of antibiotics may exacerbate the condition and promote the spread of the infection.
Treatment and Prevention
Oral antifungal medications are usually not required. A 2% sodium bicarbonate solution can be used to clean the oral cavity before and after feeding. Alternatively, a solution of nystatin (100,000–200,000 U/ml) can be applied topically 2–3 times a day. Oral administration of probiotics for gut health may help inhibit fungal growth. Preventive measures include maintaining proper breastfeeding hygiene, improving nutritional intake, and appropriately increasing the intake of vitamins B2 and C.