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Candidiasis, Oral, Emergency Medicine

Derrick D. Fenchel and Deepi G. Goyal Reviewed 06/2017
 


Basics

Description

  • Infection of oral mucosa with any species of Candida

  • Up to 80% of isolates are Candida albicans (most common), Candida glabrata, and Candida tropicalis.

  • Candida normally present as ora...

Diagnosis

Signs and Symptoms

  • Pseudomembranous candidiasis (thrush):

    • Painless white mucosal plaques

    • Adherent but removable plaques

    • Erythematous base

    • May become confluent and curdlike

    • Anorexia, dysphagia

  • Acute...

Treatment

Ed Treatment/Procedures

  • IV fluids if dehydration and/or unable to tolerate PO fluids

  • Topical analgesia: “Magic mouthwash”:

    • Mixture of equal parts of 2% viscous lidocaine, Maalox, and diphenhydr...

Follow-Up

Disposition

Admission Criteria

  • Inability to tolerate oral intake

  • Newly diagnosed immunocompromised state

  • Systemic infection

Discharge Criteria

If the candidiasis does not threaten patient's hydrat...

Pearls and Pitfalls

  • Failure to recognize immunodeficiency

  • Failure to recognize other intraoral pathology such as squamous cell carcinoma

Additional Reading

  • Gonsalves  WC, Chi  AC, Neville  BW. Common oral lesions: Part I. Superficial mucosal lesions. Am Fam Physician.  2007;75:501–507.

  • Krol  DM, Keels  MA. Oral conditions. Pediatr ...

Codes

ICD9

  • 112.0 Candidiasis of mouth

  • 771.7 Neonatal Candida infection

ICD10

  • B37.0 Candidal stomatitis

  • P37.5 Neonatal candidiasis

SNOMED

  • 79740000 Candidiasis of mouth (disorder)

  • 30799000 neonatal thrush (diso...

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