TY - CHAP M1 - Book, Section TI - Thrush (Oral Candidiasis) A1 - Jauch, Edward C. A1 - Valdez, J. Amadeo A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - White, flaky, curd-like plaques covering the tongue and buccal mucosa with an erythematous base are typical of thrush. These lesions tend to be painless, although some patients experience a burning sensation. Painful inflammatory erosions or ulcers may be noted, particularly in adults. Predisposing factors include antibiotic use, inhaled and oral corticosteroids, radiation to the head and neck, extremes of ages, patients with immunologic deficiencies, and chronic irritation (eg, denture use and xerostomia). Colonization of surface epithelium by Candida occurs due to altered oral microflora. Hairy leukoplakia, lingual lichen planus, flecks of milk or food debris, and liquid antacid adhering to the tongue may be confused with candidiasis. Hairy leukoplakia cannot be removed with a tongue depressor (note Fig. 20.4). This helps differentiate this process from thrush or residue from ingested materials. Microscopic examination of the removed specimen for the presence of hyphae in potassium hydroxide mount will aid in the identification of Candida. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/04/18 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181040697 ER -