29th July 2023

Oropharyngeal candidiasis

‘Oral thrush’ is another common form of candidiasis. In addition to the general risk factors for candidiasis, poor dental hygiene, smoking, malnutrition, and those with dental prostheses are an additional risk.

The most common form is pseudomembranous oral candidiasis, which presents with distinctive white-yellow plaques in the oral cavity. Unlike diseases like leukoplakia, these can be easily removed, which is an important distinguishing factor. Diagnosis is generally clinical, and swabs are not required.

In a non-immunocompromised individual, 2 weeks of treatment with a topical antifungal, such as miconazole gel or Nystatin, is recommended. Oral fluconazole can be used in severe cases.

In immunocompromised patients, the first line treatment is the same, but there is a higher risk of recurrent infection, spread to the oesophagus, or systemic infection, so the patient should be closely monitored for these complications.