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What is Thrush?

What is Thrush and What Can Be Done About It?


Updated June 02, 2014

We have all had morning mouth; that stale, pasty, bad tasting coating on your tongue each morning. Most likely, that coating is a type of fungal infection known as thrush. Oral thrush is the most common HIV opportunistic infection. What is thrush and what can be done to keep it at bay?

Opportunistic Infection Fact Sheets

What is Thrush?

Candida albacans is a type of fungus naturally found in our body. A strong immune system keeps the fungus at bay, preventing it from growing out of control. But in people who have weakened immune systems such as people infected with HIV, the fungus grows unchecked, appearing in colonies of white patches in the mouth, throat, esophagus (food tube) and vagina. Candiasis found in the mouth is called thrush.

Is Thrush Dangerous?

Thrush itself is not a dangerous condition. However, fungus that grows in the throat or esophagus (esophageal candidiasis) can be. In fact, esophageal candidiasis is one of several AIDS defining illnesses. Therefore, it is important to know what to look for and when to alert your doctor that you may be having a problem with thrush.

What Are the AIDS Defining Illnesses?

How Do I Know I have Thrush?

Thrush appears as white patches in the mouth. Usually they can be seen on the tongue, inside the cheeks, under the tongue, and in the back of the throat. In the mouth, thrush can cause pain especially after scraping the white patches off of the tongue. As it progresses down the throat and into the esophagus, it can cause a sore throat, inability to swallow, loss of appetite, nausea and chest pain. Left unchecked, esophageal candidiasis can cause severe respiratory complications.

This is What Thrush Looks Like

How is Thrush Treated?

If the fungal growth is limited to the mouth, there are simple topical drugs that can help. Nystatin (Mycostatin) liquid is used by swishing a bit in your mouth several times a day and then swallowing the medicine. Throat lozenges called Mycelex trouches are slowly dissolve in the mouth like a cough drop, distributing medicine to the infected areas. This type of therapy is usually more effective in fighting thrush because the medicine stays in longer contact with the surfaces in the mouth that are affected. In people with recurrent thrush, oral medications such as Diflucan (fluconazole) is used.

Can Thrush be Prevented?

While thrush can occur in HIV patients with high CD4 counts, there are steps that can be taken to lessen the frequency of thrush. Good oral hygiene such as brushing after each meal, gargling with antiseptic mouth washes (e.g. Listerine) and smoking cessation can go a long way in keeping the mouth healthy. If the severe type of yeast infection (candida esophagitis) reoccurs, oral preventative medications can be used. Certain dietary changes can also help. Limiting the amount of sugar and alcohol consumed as well as eating more yogurt and dairy products can help to prevent outbreaks of thrush.If you think you have thrush or other fungal infections, consult your doctor.

Understanding CD4 Counts

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