From the Research
Oral thrush in pediatric patients is diagnosed through clinical examination and identification of characteristic white, curd-like lesions on the oral mucosa, tongue, and sometimes the palate, with confirmation made by microscopic examination of scrapings mixed with potassium hydroxide (KOH) or by culture, as supported by recent studies 1, 2. The diagnostic criteria for oral candidiasis (thrush) in pediatric patients include:
- Clinical examination to identify characteristic white, curd-like lesions on the oral mucosa, tongue, and sometimes the palate
- Microscopic examination of scrapings mixed with potassium hydroxide (KOH) to confirm the presence of Candida albicans
- Culture to confirm the diagnosis and identify the specific species of Candida The most recent and highest quality study 1 provides a comprehensive review of the therapeutic tools available for oral candidiasis, including nystatin, miconazole, and fluconazole, which are effective for treating oral candidiasis. Other studies 3, 4, 2, 5 also support the use of these diagnostic criteria and treatment options, but the most recent study 1 provides the most up-to-date and comprehensive information. It is essential to note that oral thrush can occur after antibiotic use, which disrupts normal oral flora, or in immunocompromised children, so addressing underlying conditions is crucial for effective management, as highlighted in the study 3. In terms of treatment, fluconazole (3-6 mg/kg once daily for 7-14 days) may be used for resistant cases, and nystatin oral suspension (100,000 units/mL) can be administered as 1-2 mL four times daily for 7-14 days, as supported by the study 4. Additionally, good oral hygiene, proper bottle cleaning, and limiting pacifier use can help prevent recurrence, and treating the mother's nipples with an antifungal cream like miconazole is important to prevent reinfection in breastfed infants, as mentioned in the study 2.