Management Of Oral Thrush/Oral Candidiasis

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This will be one of the commonest abnormalities found in the mouth. Diagnosed when whitish patches or reddening of the oral mucosa is noted. The condition may be associated with a feeling of not tasting food well plus odynophagia (pain in the chest on swallowing). Angular cheilitis is ulceration and occasional bleeding at the corner of the mouth. Apart from suspecting HIV related disease, exclude the current use of antibiotics, steroids or the presence of diabetes mellitus. Offer HIV testing and counselling (HTC).

Treat with topical therapy such as:

	Medicine	Adult Dose	Frequency	Duration
	nystatin suspension po	200,000 units	5 times a day	7-14 days
or	nystatin lozenges po	sucked	5 times day	7-14 days
or	miconazole oral gel	topically	4 times a day	7-14 days

If there is odynophagia, treat as oesophageal candidiasis as follows:

Oesophageal Candidiasis

This is an AIDS defining illness (WHO Stage 4 disease) and hence the patient would need to be worked up for referral to the OI Clinic for ARV therapy. Offer HTC and consider giving Cotrimoxazole prophylaxis.

Treat oesophageal candidiasis with systemic medicines such as:

Medicine	Adult Dose	Frequency	Duration
fluconazole po	200mg	twice a day	7-14 days

• Nutritional rehabilitation is indicated.
• Exclude other Ols such as TB/KS
• Refer to OI Clinic.