Oral and oropharyngeal candidiasis


Infection due to Candida albicans, common in infants, immunocompromised or diabetic patients. Other risk factors include treatment with oral antibiotics or high-dose inhaled corticosteroids.

Clinical features

White patches on the tongue, inside the cheeks, that may spread to the pharynx.

In patients with frequent recurrences or extensive forms invading the esophagus (swallowing difficulty and pain), consider HIV infection.

Treatment

To be taken between meals:
nystatin lozenge to be sucked or oral suspension
Children and adults: 400 000 IU daily, i.e. one lozenge to be sucked or 1 ml of the oral suspension (100 000 IU) 4 times daily
or 
miconazole oral gel
Children 6 months to 2 years: 1.25 ml 4 times daily 
Children over 2 years and adults: 2.5 ml 4 times daily 

The oral suspension of nystatin or the oral gel of miconazole should be kept in the mouth for 2 to 3 minutes and then swallowed, or, in young children, applied to the tongue and inside of each cheek.

Show the mother how to treat since, in most cases, candidiasis will be treated at home.

In immunocompromised patients: see HIV infection and AIDS, Chapter 8.