ORAL MONILIASIS

ORAL MONILIASIS
 Oral moniliasis is a yeast
infection of the mouth and
throat caused by a fungus
formerly called Monilia, now
known as Candida albicans.
 This infection is also known
as thrush.
 Yeast organisms are part of the
germs normally found in various
parts of the body.
 They ordinarily do not cause any
symptoms.
Oral thrush occurs when
a yeast infection
develops on the inside
of your mouth and on
your tongue.
This condition is also
known as oral
candidiasis,
oropharyngeal
candidiasis, or, simply,
thrush.
 The Candida albicans (C.
albicans) fungus causes oral
thrush. A small amount of this
fungus normally lives in your
mouth without causing harm.
 However, when the fungus
begins to grow uncontrollably, an
infection can develop in your
mouth.
 Oral thrush most often occurs in
infants and toddlers. It causes
white bumps to form on the inner
cheeks and tongue. These
growths usually go away once
treatment is received.
 SIGNS AND SYMPTOMS
In its initial stages, oral thrush may not cause any symptoms.
However, as time passes and the fungus continues to grow,
the following symptoms may develop:

Creamy white bumps on

the tongue, inner cheeks, gums,
or tonsils
Slight bleeding when the bumps
are scraped
Pain at the site of the bumps
Angular cheilitis, or dry, cracked skin
at the corners of the mouth
Difficulty swallowing
A bad taste in the mouth
 ASSESSMENT
If thrush is limited to your mouth
To diagnose oral thrush, your doctor or dentist
may:
 Examine your mouth to look at the lesions
 Take a small scraping of the lesions to
examine under a microscope
 If needed, do a physical exam and certain
blood tests to identify any possible
underlying medical condition that may be
the cause of oral thrush
If thrush is in your esophagus
 To help diagnose thrush in your
esophagus, your doctor may
recommend any or all of these:
 Biopsy. The tissue sample is cultured on
a special medium to help determine
which bacteria or fungi, if any, are
causing your symptoms.
 Endoscopic exam. In this procedure,
your doctor examines your esophagus,
stomach and upper part of your small
intestine (duodenum) using a lighted,
flexible tube with a camera on the tip
(endoscope).
 Physical exam. If needed, a physical
exam and certain blood tests may be
done to try to identify any possible
underlying medical condition that
could cause thrush in the esophagus.
 NURSING MANAGEMENT


1. Inspect oral cavity at least once daily and note

any discoloration, lesions, edema, bleeding,
exudate, or dryness. Refer to a physician or
specialist as appropriate.
2. Assess for mechanical agents such as ill-fitting
dentures or chemical agents such as frequent
exposure to tobacco that could cause or
increase trauma to oral mucous membranes.

3. Monitor client's nutritional and fluid status to
determine if adequate.
4. Encourage fluid intake up to 3000 ml per day
if not contraindicated by client's medical
condition (Rhodes, McDaniel, Johnson, 1995).

5. Determine client's mental status. If client is
unable to care for self, oral hygiene must be
provided by nursing personnel.

6. Determine client's usual method of oral care
and address any concerns regarding oral
hygiene.

 7. If client does not have a bleeding disorder and is
able to swallow, encourage to brush teeth with a soft
pediatric-sized toothbrush using a fluoride-containing
toothpaste after every meal and to floss teeth daily. '
8. Use tap water or normal saline to provide oral care;
do not use commercial mouthwashes containing
alcohol or hydrogen peroxide. Also, do not use lemon-
glycerin swabs.

 9. If whitish plaques are present in the mouth or on the

tongue and can be rubbed off readily with gauze,
leaving a red base that bleeds, suspect a fungal
infection and contact the physician for follow-up.
 MEDICAL MANAGEMENT
 Include antifungal agents either nystatin troches or
liquid to swish and spit or systemic therapy with
Fluconazole. (the antifungal infection alleviate the
infection)
 Topical or oral analgesics, such as acetaminophen or
ibuprofen may also be administered to reduce pain.
 Mouthwashes or warm saline (or water) are often
ordered as part of an oral hygiene regimen.
 A liquid or pureed diet may be necessary.
 MEDICAL TREATMENTS
The following medical treatments may
be used for oral thrush.
 Fluconazole
(Diflucan). Fluconazole is an oral
antifungal medication.
 Clotrimazole (Mycelex Troche). Your
doctor will prescribe the lozenge
form of this antifungal medication.
The medication is left in the mouth
until it dissolves.
 Nystatin (Nystop, Nyata). This is an
antifungal mouthwash that you
swish around in your mouth and
then swallow. In an infant, it’s
swabbed in the mouth.
 Itraconazole (Sporanox). This oral
antifungal is used for people who
are resistant to initial treatments
or who have HIV.
 Amphotericin B (AmBisome,
Fungizone). This drug is used to
treat severe cases.