Oral candidiasis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
There are no sequelae with appropriate antifungal therapy. In contrast, among immunocompromised patients with disseminated infections, the morbidity and mortality are very high.
Natural history
- Thrush in infants may be painful, but is rarely serious. If it does not resolve on its own within 2 weeks, a pediatrician must be notified.
- In adults, thrush that occurs in the mouth can be cured. However, the long-term outlook is dependent on a persons immune status and the cause of the immune deficit.
- In patients with immunodeficiency (HIV-positive or receiving chemotherapy), Candida can spread throughout body, causing esophagitis,meningitis, endocarditis, arthritis, or endophthalmitis.
Complications
Oropharyngeal candidiasis is rarely complicated except in immunocompromised individuals.
- Thrush in infants may cause weight loss because of dysphagia and discomfort associated with it.
- Spread to the trachea or the esophagus (causing respiratory distress or esophagitis) is rarely seen in otherwise healthy individuals.
- Systemic spread causing candidaemia and distant candida infection is frequently seen in immunocompromised individuals.
Prognosis
- Prognosis of oropharyngeal candidiasis is excellent in otherwise immunocompetent individuals with no serious sequelae in the majority of cases.
- Special attention should be given to immunocompromised patients as local spread to the trachea or esophagus or systemic spread causing candidaemia or distant candidiasis can be very serious with very high mortality rate.