Oral Candidiasis

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Copyright 2006 Martin S. Spiller, D.M.D. courtesy of Dr. Ed Cataldo

The image above shows pharyngal candidiasis.  Candidiasis (thrush) in this location suggests that the patient is either suffering from AIDS, or is using an oral corticosteroid inhaler.  In this case, note also the redness at the corners of the lips.  This is a sign of angular cheilitis which is a yeast infection of the corners of the lips.  This combination of pharyngal and angular Candida infection are strongly indicative of underlying HIV infection.

Copyright 2006 Martin S. Spiller, D.M.D. courtesy of Dr. Ed Cataldo

Oral Candida infections of the tongue are very frequent in elderly persons who wear dentures.  The elderly are often plagued with dry mouth (xerostomia) which is quite conducive to Candida infection.

Copyright 2006 Martin S. Spiller, D.M.D. courtesy of Dr. Ed Cataldo

The above image of an infant shows the most common manifestation of oral Candida infection.  In infants it is called Thrush.

Thrush is a yeast infection often found in infants (bottom image).  The organism responsible is called Candida albicans.  The reason that thrush is found in infants and not in adults is that infants have not yet developed an entirely competent immune system.  Oral yeast infections are not often found in healthy adults unless they are suffering from a compromised immune system.  The reasons why an adult may have developed a compromised immune system include various chronic diseases and physical or psychological stress. 

The most frequent cause of immune compromise leading to oral yeast infections today is the presence of HIV which has progressed into AIDS.  Persons with AIDS often develop pharyngal (throat) candidiasis (see the top image on this page).  In the early history of the AIDS epidemic, it was believed by many clinicians that pharyngeal candidiasis was pathognomonic (found only in) AIDS patients.  It did not take very long to discover that a very common cause of pharyngeal candidiasis is the chronic usage of corticosteroid inhalers. 

The distinguishing characteristic of an oral candida infection is a series of white plaques which are easily scraped off revealing an underlying erythematous (red) area.  This condition is most easily confused with leukoplakia, which is tough and leathery and not easily scraped off the underlying tissue.