Oropharyngeal candidiasis: Difference between revisions
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==Workup== | ==Workup== | ||
*Most cases are diagnosed clinically and need only one of the treatments listed below. | |||
*Consider HIV testing if no other etiology is determined or if risk factors are present. | |||
==Management== | ==Management== | ||
Revision as of 18:19, 7 June 2014
Background
- Typically occurs when the normal host immunity or host flora are disrupted, allowing for overgrowth of Candida albicans.
Risk Factors
- Extremes of age
- Antibiotics
- Corticosteroids
- Immunocompromised (AIDS, immunosuppressant medications)
Clinical Features
- White curd-like plaques that are difficult to remove and leave behind an erythematous base
- Usually painless
Differential Diagnosis
Tongue diagnoses
- Tongue laceration
- Strawberry tongue
- Black hairy tongue
- Oropharyngeal candidiasis (oral thrush)
- Hairy Oral Leukoplakia
- Tongue swelling
- Trauma
- Angioedema
- Hereditary
- Allergic (ACE)
- Idiopathic
Workup
- Most cases are diagnosed clinically and need only one of the treatments listed below.
- Consider HIV testing if no other etiology is determined or if risk factors are present.
Management
- Nystatin oral suspension 400,000-600,000 units (swish and swallow) Q6H until 48 hours after symptoms disappear OR
- Clotrimazole 10 mg troches 5 times/day for 14 consecutive days OR
- Fluconazole 200 mg (Peds: 6 mg/kg) PO on day one, followed by 100 mg (Peds: 3 mg/kg_ daily for two weeks.