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Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Thrush is caused by an overgrowth of the yeast Candida albicans, which is commonly found on skin surfaces, the oral cavity, and throughout the intestinal tract of healthy individuals. Newborn infants often are exposed during delivery and may develop oral evidence of thrush within 10 days post-delivery. Breastfeeding infants may infect their mother's nipple area during breastfeeding. In addition, an overgrowth of Candida in the stool may be associated with a characteristic diaper rash. Contamination of formula bottle nipples and pacifiers with Candida may also introduce the yeast into a child's oral cavity.

In older children and adults, oropharyngeal candidiasis is associated with several risk behaviors including prolonged or repeated oral antibiotics, smoking, dentures, use of birth control pills and diabetes (either type I or type II). Perhaps the most common association for developing thrush is improper technique during the use of inhalers containing corticosteroids for the control of asthma or COPD (chronic obstructive pulmonary disease). Such medications require water rinsing and spitting out in order to eliminate any non-inhaled medication. Patients using a metered dose inhaler (MDI) for administration of their steroids are recommended to use a "spacer" to lessen the amount of potential residual steroid left in the mouth. Immune-compromised individuals more commonly experience thrush compared with their healthy counterparts.

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