From the Guidelines
Oral thrush in adults is typically diagnosed through a clinical examination by a healthcare provider, prioritizing a visual inspection of the mouth for characteristic white, creamy lesions, and may involve further testing such as microscopic examination or culture to confirm the presence of Candida albicans, as recommended by the most recent guidelines 1. The diagnosis of oral thrush in adults is crucial for proper treatment and management of the condition. According to the ESCMID guideline for the diagnosis and management of Candida diseases 2012, diagnostic procedures should include conventional methods of microbiological diagnosis, such as microscopical examination and culture, as well as alternative diagnostic procedures like non-culture-based techniques for biomarker detection 1. Some key points to consider in the diagnosis of oral thrush in adults include:
- Visual inspection of the mouth to identify characteristic white, creamy lesions on the tongue, inner cheeks, or throat that can be scraped off, revealing a red, sometimes bleeding surface underneath
- Microscopic examination or culture of a swab from the affected area to confirm the presence of Candida albicans
- Blood tests to check for underlying conditions that can predispose to thrush, such as diabetes or immune system disorders, especially in cases of recurrent or severe infection
- Consideration of the patient's medical history, including recent antibiotic use, corticosteroid inhaler use, immune suppression, or poor oral hygiene, which can disrupt the normal oral microbiome and contribute to the development of thrush 1. The most effective approach to diagnosing oral thrush in adults involves a combination of clinical examination, laboratory testing, and consideration of the patient's medical history, as outlined in the most recent and highest quality study 1.
From the Research
Diagnosis of Oral Thrush in Adults
- Oral thrush, also known as oral candidiasis, is a common opportunistic oral infection that can present with different acute and chronic clinical presentations 2.
- The diagnosis of oral thrush can be challenging due to its similarity with other white lesions in the oral cavity, and clinicians must be well-acquainted with its appearance and features to make an accurate diagnosis 3.
- The clinical presentation of oral thrush typically involves whitish patches or erythema over the buccal mucosa, tongue, and palate, and can be predisposed by factors such as compromised immunity, certain drugs, poor oral hygiene, and ill-fitting dentures 3, 4.
Diagnostic Approaches
- Oral physicians play a key role in the diagnosis of oral thrush, and prompt treatment can be advised once the lesion is diagnosed 3.
- The diagnosis of oral candidiasis involves a thorough examination of the oral cavity and consideration of the patient's medical history 5, 4.
- A diagnosis of oral thrush can be made based on the presence of characteristic clinical features, such as whitish patches or erythema, and can be confirmed by laboratory tests such as microscopy or culture 4.
Treatment Options
- Topical antifungal agents, such as nystatin, miconazole, and fluconazole, are commonly used to treat oral thrush in adults 2, 6.
- Systemic antifungal agents, such as itraconazole and voriconazole, may be used to treat more severe or recurrent cases of oral thrush 2, 6.
- The choice of treatment depends on the severity of the infection, the patient's immune status, and the presence of any underlying medical conditions 6.