Oral Thrush Managed As Allergy

I saw a baby in the clinic with swollen lip and congested nose. This baby was not seen but triaged by a independent nurses consultant.

oral thrush

Wrong treatment by nurse

The mother came to see me because the rash started spreading on the chin. She thought this was “Thrush” but her confidence was undermined because of the advice given by a nurse and was confused because she did not know what the nurse meant by antihistamine.

The nurses when questioned by me was not aware vaseline can help fungus to thrive and spread.

This is an example to show how of simple mistake, managed wrong can result in prolonging illness, suffering and complications that can at times be devastating.

Complications

oral thrush2

Wrong treatment by doctors

Babies with severe thrush develop ulcers in the mouth. They will not feed well because of pain and so can get dehydrated. The fungus can spread to intestine and also produce nappy thrush. If the child was breast fed, the mother could infected and her breast will be sore.

Infection in individual who is immune-suppressed (children treated with steroids, cancer treatment or post transplant surgery) can go on to develop serious systemic infection.

No mortality is associated if correctly diagnosed and treated early. However, a thrush incorrectly diagnosed or treated as eczema or oral ulcers (using bonjella) may lead to significant morbidity and mortality. Existence of resistant bacteria, fungus and HIV has made treating this common problem very complex.

Morbidity associated with rash is discomfort and the possibility of secondary bacterial  infections which may be more severe in an individual who is immune-compromised. Immune-compromised are more susceptible to infections and other resistant bacterial super-infections.

All About Oral Thrush You Must Know

Disclaimer

All content I provide must be used for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. Dr Sri is not responsible or liable for any diagnosis made by a user based on the content of this blog or my website. Dr Sri is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Please read my disclaimer and register as a user of this blog. Always consult your own doctor if you’re in any way concerned about your health.

ORAL THRUSH

Common infection in babies also known as candidiasis. This is an infection of the mouth caused by a a fungus (yeast) called Candida albicans. 

Symptoms

Whitish curdy, creamy or yellow raised spots on the surface of the pink membranes in the mouth. This is often confused with milk residues on a baby’s tongue after a feed. The way you can differentiate milk from fungus is to scrape the tongue using the edge of a spoon or a wooden spatula (tongue depressor). If the curdy area can be removed and the surface of the tongue looks leaving a tender, red area beneath, which may bleed – this is likely to be thrush. The raw area may or may not be very painful but will make it difficult for babies to feed or suck milk.

The babies with oral thrush often have or will develop severe nappy rash because the fungus will pass through the stomach, intestine and come out in the stools to grow in the nappy area. (I will publish an article to gel you learn all about nappy rash)

Older children and adults may complain of burning or soreness in the mouth or throat, or at the angles of the lips. Thrush doesn’t usually cause a temperature – if your baby has a fever it is likely the child has secondary infection and so you must consult a “DOCTOR”

Causes & Risk

Fungus is present on our body, mouth, groin, vagina, nose, ears and skin. These organisms do not generally cause serious problem but can cause serious complication if the immune system of the baby or adult is weakened or the normal environment of the mouth changes (if the healthy bacteria are killed, for example, or if too little saliva is produced or the acidity of the mouth changes) or suppressed by drugs (cancer, steroid, immune spressors post transplant), HIV infection, Combined immuneo-deficienies or other rare conditions. Trush is very common in women. Most develop vaginal itch often after taking some antibiotics treatment.

Babies are prone to catch this infection early because they do not have not developed the immunity. Some babies (Congenital immune deficients, HIV, De-Georgies Syndrome or others) do not develop immunity to fungus infection and may go on to develop serious complication – generalised fungus infection that is very difficult to treated.

These factors include anything that reduces natural resistance, such as general illness, viral infections, antibiotics (which kill off the protective bacteria in the mouth) and other medications, including the steroids often used in asthma treatments.

Almost everyone who wears dentures will have candida in their mouths but problems only tend to develop when they don’t fit properly and damage the delicate membranes in the mouth. Oral thrush is common in newborn babies but rarely linked to any serious problems. In children and adults, exposure to the factors that encourage the growth of candida (in this case using Vaseline) may lead to complications

Treatment & Recovery

In most cases, especially in babies, thrush can be diagnosed simply by looking at the spots. In difficult cases a sample may be scraped off and sent to the laboratory for analysis.

The lesion must be diagnosed early and treated adequately if not the infection may spread or relapse is very common.

Treatment consists of anti-fungal medicines such as Nystatin (which can be given as drops or pastilles) or Miconazole (Daktarin Gel).

Please note the oral drops and cream are available in the local pharmacy and so can be bought without prescription. The chemist / pharmacists have the information about this drug. You can also read more information about the drugs and side effects by clicking on the names of the drugs.

Important & Useful Information

  1. Always give oral treatment after every feed.
  2. Please note this is a safe drug to use in adults or children.
  3. You must Always start treating Nappy Area with Cream
  4. You cannot use oral drops in the nappy area and nappy cream cannot be used in the mouth.
  5. Please make sure you do tell the doctors if the child is on antibiotics, steroid or any other illness in the family including HIV
  6. Make sure you check your breast to see if the nipples are cracked and infected.

It’s unusual for a breastfeeding baby to develop thrush, but if this happens the mother should use an antifungal cream on her nipples to prevent cross-infection between mother and child.

In bottle-fed babies, the bottle teats should be thrown away and new ones bought because the yeast may get into the teats and cannot be easily eradicated.

Babies must be treated using antifungal cream on their bottoms (nappy area) because the fungus living in the mouth will come through the anus (stools) and infect the nappy area.

Oral thrush usually responds quickly to these treatments. If it the infection does not resolve and persists, the child or adult MUST be investigated.

PS: Will be publishing information about Nappy Rash. Please leave a message if you would like me to publish specific article on any medical topic.

REFERENCE

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  1. Google Search: Oral Thrush
  2. Images of Oral Thrush

 

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