What Is Thrush?

Thrush is common in people of all age groups. The infection does not always present with symptoms.

Thrush is an infection caused by the candida species. The most common species being candida albicans.

This article will guide you through some important information regarding the pathogenesis of thrush.

Overview

Thrush is an infection that is caused by the fungus called Candida albicans. Candida albicans is a species found in the normal flora of a healthy individual. Candida albicans colonizes the oral, gastrointestinal and genital tract without presentation of symptoms. The fungus usually travels to parts of the body to cause infection. The two types of infection are either mucosal or systemic. Skin invasion is very rare but does occur in those who have inborn errors of immunity. Thrush affects both males and females but is not considered to be a sexually transmitted infection.

Causes of thrush

Thrush is caused by an infection by fungus microorganism, candida albicans which is a common commensal habitat of the human gut. Although it is usually harmless, thrush can be triggered by sex. The favourable conditions for the infection to thrive are moist, warm environments along with microbiota imbalance.

Signs and symptoms of thrush

The symptoms of thrush are; 

• Whitish patches occurring on the surface of the labial and buccal mucosa, hard and soft palate, tongue, periodontal tissues, and oropharynx. The membrane can usually be scraped off with a swab to expose an underlying erythematous mucosa.
• Local discomfort usually a sore tongue or itching or irritation  in the affected area as well as pain on urination 
• Altered taste sensation 
• Dysphagia
• Poor nutrition 
• Odourless vaginal discharge 

 Sometimes there are no symptoms in those who are carriers of candida species.

Management and treatment for thrush

Thrush can be managed through various options with advice being offered from sources that offer information and support to enable the patient to self-manage their symptoms and provide relief. The assessment will help the health professional to ascertain the cause of the infection as well as rule out if they are at risk of developing complications due to underlying disease. Antifungal drugs are also advised with a follow-up being arranged to check if the treatment has been successful or if further action is needed.

Diagnosis of thrush

Diagnosis can be confirmed microbiologically either by staining a smear from the affected area or by culturing a swab from an oral rinse. The high vaginal swab can be cultured to confirm the diagnosis as well as sensitivity testing to find out which drug will treat the infection most effectively.

Risks factors of thrush

• Neonates who are still developing their microbiota are susceptible to developing an infection by Candida species
• The elderly are also commonly affected by thrush due to their natural flora deteriorating due to ageing
• The immunocompromised individuals(HIV, cancer patients and diabetics) also account for the epidemics of infections caused by candida species 
• Users of broad-spectrum antibiotics which alter normal flora thus causing overgrowth of other microorganisms

Complications 

If thrush is left untreated it can result in mortality and morbidity. The other issue is recurrent infection, reduced quality of life and psychosexual difficulties.

FAQs

Can thrush be prevented

Thrush can be prevented by using water and gentle creams instead of soap to wash the areas of concern. Following this washing you should dry your body properly. It is better to wear cotton underwear as it is a comfortable material. Sexual activities should be avoided until the thrush infection has cleared.

Is thrush contagious

Thrush can be transmitted through sexual intercourse although it is not considered as an STI.

How common is thrush

Thrush is very common in both males and females, 20% of women of reproductive age are colonized with asymptomatic Candida species.

When should I see a doctor

You should visit a doctor if you have symptoms of thrush. It is advised that you seek medical attention when you have recurrent infections as well as when the treatment options are failing to cure the thrush. The immunocompromised individuals should also inform a general practitioner in order to start treatment.

Summary

The infection by candida albicans is common in those with an imbalance of microbiota. Neonates with an underdeveloped immune system are at risk of developing this infection as well as those with weakened immunity such as those with cancers. The infection can be treated with antifungals when confirmed by culture of the overgrowth of candida species.