Medscape is available in 5 Language Editions – Choose your Edition here.


Thrush Treatment & Management

  • Author: Mudra Kumar, MD, MRCP, FAAP; Chief Editor: Russell W Steele, MD  more...
Updated: Apr 29, 2016

Medical Care

Although some anecdotal reports indicate no treatment is necessary for otherwise healthy neonates, no published studies support this assertion.[9]



In cases in which underlying immune dysfunction is suspected, consultation with an immunologist and infectious diseases specialist may be warranted for further evaluation.



No special diet is indicated.

Contributor Information and Disclosures

Mudra Kumar, MD, MRCP, FAAP Professor of Pediatrics, Course Director, Course 6 MSII, Preclerkship Director, Clinical Integration, Department of Pediatrics, University of South Florida Morsani College of Medicine

Mudra Kumar, MD, MRCP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Society of Hematology, American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Leonard R Krilov, MD Chief of Pediatric Infectious Diseases and International Adoption, Vice Chair, Department of Pediatrics, Winthrop University Hospital; Professor of Pediatrics, Stony Brook University School of Medicine

Leonard R Krilov, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Society for Pediatric Research

Disclosure: Nothing to disclose.


Leslie L Barton, MD Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

  1. Gillies M, Ranakusuma A, Hoffmann T, Thorning S, McGuire T, Glasziou P, et al. Common harms from amoxicillin: a systematic review and meta-analysis of randomized placebo-controlled trials for any indication. CMAJ. 2015 Jan 6. 187 (1):E21-31. [Medline].

  2. Pullen LC. Amoxicillin Adverse Effects Underreported, Underrecognized. Medscape Medical News. Available at November 19, 2014; Accessed: June 16, 2015.

  3. [Guideline] Pappas PG, Kauffman CA, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009 Mar 1. 48(5):503-35. [Medline].

  4. Hoppe JE. Treatment of oropharyngeal candidiasis and candidal diaper dermatitis in neonates and infants: review and reappraisal. Pediatr Infect Dis J. 1997 Sep. 16(9):885-94. [Medline].

  5. Kalfa VC, Roberts RL, Stiehm ER. The syndrome of chronic mucocutaneous candidiasis with selective antibody deficiency. Ann Allergy Asthma Immunol. 2003 Feb. 90(2):259-64. [Medline].

  6. Liu X, Hua H. Oral manifestation of chronic mucocutaneous candidiasis: seven case reports. J Oral Pathol Med. 2007 Oct. 36(9):528-32. [Medline].

  7. Rowen JL. Mucocutaneous candidiasis. Semin Perinatol. 2003 Oct. 27(5):406-13. [Medline].

  8. Tooyama H, Matsumoto T, Hayashi K, Kurashina K, Kurita H, Uchida M, et al. Candida concentrations determined following concentrated oral rinse culture reflect clinical oral signs. BMC Oral Health. 2015 Nov 24. 15:150. [Medline].

  9. Raucher HS. Should we be treating oral thrush?. Pediatr Infect Dis J. 1998 Mar. 17(3):267. [Medline].

  10. Lyu X, Zhao C, Yan ZM, Hua H. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis. Drug Des Devel Ther. 2016. 10:1161-71. [Medline].

  11. Adams NP, Bestall JC, Lasserson TJ, et al. Fluticasone versus placebo for chronic asthma in adults and children. Cochrane Database Syst Rev. 2005. CD003135. [Medline].

  12. Allen G, Logan R, Gue S. Oral manifestations of cancer treatment in children: a review of the literature. Clin J Oncol Nurs. 2010 Aug. 14(4):481-90. [Medline].

  13. Aytekin C, Dogu F, Tuygun N, Tanir G, Guloglu D, Boisson-Dupuis S, et al. Bacille Calmette-Guérin lymphadenitis and recurrent oral candidiasis in an infant with a new mutation leading to interleukin-12 receptor beta-1 deficiency. J Investig Allergol Clin Immunol. 2011. 21(5):401-4. [Medline].

  14. Baley JE. Neonatal candidiasis: the current challenge. Clin Perinatol. 1991 Jun. 18(2):263-80. [Medline].

  15. Brown RS, Berg W, Schlesinger W, Childers EL. The CDx brush biopsy and the diagnosis of oral candidiasis. Dent Today. 2007 Aug. 26(8):96, 98-9. [Medline].

  16. Butler KM, Baker CJ. Candida: an increasingly important pathogen in the nursery. Pediatr Clin North Am. 1988 Jun. 35(3):543-63. [Medline].

  17. Conti HR, Baker O, Freeman AF, Jang WS, Holland SM, Li RA, et al. New mechanism of oral immunity to mucosal candidiasis in hyper-IgE syndrome. Mucosal Immunol. 2011 Jul. 4(4):448-55. [Medline]. [Full Text].

  18. Domaneschi C, Massarente DB, de Freitas RS, de Sousa Marques HH, Paula CR, Migliari DA, et al. Oral colonization by Candida species in AIDS pediatric patients. Oral Dis. 2011 May. 17(4):393-8. [Medline].

  19. dos Santos Pinheiro R, Franca TT, et al. Oral manifestations in human immunodeficiency virus infected children in highly active antiretroviral therapy era. J Oral Pathol Med. 2009 Sep. 38(8):613-22. [Medline].

  20. Egusa H, Soysa NS, Ellepola AN, Yatani H, Samaranayake LP. Oral candidosis in HIV-infected patients. Curr HIV Res. 2008 Nov. 6(6):485-99. [Medline].

  21. Gonzalez Gravina H, Gonzalez de Moran E, Zambrano O, et al. Oral Candidiasis in children and adolescents with cancer. Identification of Candida spp. Med Oral Patol Oral Cir Bucal. 2007 Oct. 12(6):E419-23. [Medline].

  22. Grimm SE 3rd, Lawrence L, Bailey J, Brown RS. Oral thrush in a one-month old infant: etiology and treatment. Dent Today. 2009 Jun. 28(6):55-7; quiz 57. [Medline].

  23. Jones W, Breward S. Thrush and breastfeeding. Identifying and treating thrush in breastfeeding mothers and babies. Community Pract. 2010 Oct. 83(10):42-3. [Medline].

  24. Kumamoto CA, Vinces MD. Alternative Candida albicans lifestyles: growth on surfaces. Annu Rev Microbiol. 2005. 59:113-33. [Medline].

  25. Kwon-Chung KJ, Bennett JE, eds. Medical Mycology. Philadelphia, Pa: Lea & Febiger; 1992. 2288-301.

  26. Liguori G, Lucariello A, Colella G, De Luca A, Marinelli P. Rapid identification of Candida species in oral rinse solutions by PCR. J Clin Pathol. 2007 Sep. 60(9):1035-9. [Medline].

  27. Majorana A, Bardellini E, Flocchini P, Amadori F, Conti G, Campus G. Oral mucosal lesions in children from 0 to 12 years old: ten years' experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jul. 110(1):e13-8. [Medline].

  28. Marques SA. Fungal infections of the mucous membrane. Dermatol Ther. 2010 May-Jun. 23(3):243-50. [Medline].

  29. Maródi L, Cypowyj S, Tóth B, Chernyshova L, Puel A, Casanova JL. Molecular mechanisms of mucocutaneous immunity against Candida and Staphylococcus species. J Allergy Clin Immunol. 2012 Nov. 130(5):1019-27. [Medline].

  30. McCullough M, Patton LL, Coogan M, Fidel PL Jr, Komesu M, Ghannoum M, et al. New approaches to Candida and oral mycotic infections: Workshop 2A. Adv Dent Res. 2011 Apr. 23(1):152-8. [Medline].

  31. McGovern E, Fleming P, Costigan C, Dominguez M, Coleman DC, Nunn J. Oral health in Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy (APECED). Eur Arch Paediatr Dent. 2008 Dec. 9(4):236-44. [Medline].

  32. McManus BA, McGovern E, Moran GP, Healy CM, Nunn J, Fleming P, et al. Microbiological screening of Irish patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy reveals persistence of Candida albicans strains, gradual reduction in susceptibility to azoles, and incidences of clinical signs of oral candidiasis without culture evidence. J Clin Microbiol. 2011 May. 49(5):1879-89. [Medline]. [Full Text].

  33. Nokta M. Oral manifestations associated with HIV infection. Curr HIV/AIDS Rep. 2008 Feb. 5(1):5-12. [Medline].

  34. Noonan M, Leflein J, Corren J, Staudinger H. Long-term safety of mometasone furoate administered via a dry powder inhaler in children: Results of an open-label study comparing mometasone furoate with beclomethasone dipropionate in children with persistent asthma. BMC Pediatr. 2009 Jul 13. 9:43. [Medline]. [Full Text].

  35. Ozturk MA, Gunes T, Koklu E, et al. Oral nystatin prophylaxis to prevent invasive candidiasis in Neonatal Intensive Care Unit. Mycoses. 2006 Nov. 49(6):484-92. [Medline].

  36. Pankhurst C. Candidiasis (oropharyngeal). Clin Evid. 2005 Jun. 1701-16. [Medline].

  37. Perniola R, Congedo M, Rizzo A, et al. Innate and adaptive immunity in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. Mycoses. 2008 May. 51(3):228-35. [Medline].

  38. Pienaar ED, Young T, Holmes H. Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children. Cochrane Database Syst Rev. 2010 Nov 10. 11:CD003940. [Medline].

  39. Pomarico L, Cerqueira DF, de Araujo Soares RM, et al. Associations among the use of highly active antiretroviral therapy, oral candidiasis, oral Candida species and salivary immunoglobulin A in HIV-infected children. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Aug. 108(2):203-10. [Medline]. [Full Text].

  40. Puel A, Cypowyj S, Bustamante J, Wright JF, Liu L, Lim HK, et al. Chronic mucocutaneous candidiasis in humans with inborn errors of interleukin-17 immunity. Science. 2011 Apr 1. 332(6025):65-8. [Medline]. [Full Text].

  41. Roland NJ, Bhalla RK, Earis J. The local side effects of inhaled corticosteroids: current understanding and review of the literature. Chest. 2004 Jul. 126(1):213-9. [Medline]. [Full Text].

  42. Russell C, Lay KM. Natural history of Candida species and yeasts in the oral cavities of infants. Arch Oral Biol. 1973 Aug. 18(8):957-62. [Medline].

  43. Segal BH, Steinbach WJ. Combination antifungals: an update. Expert Rev Anti Infect Ther. 2007 Oct. 5(5):883-92. [Medline].

  44. Shepherd J. Thrush and breastfeeding. Pract Midwife. 2002 Dec. 5(11):24-7. [Medline].

  45. Su CW, Gaskie S, Jamieson B, Triezenberg D. Clinical inquiries. What is the best treatment for oral thrush in healthy infants?. J Fam Pract. 2008 Jul. 57(7):484-5. [Medline].

  46. Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook. 7th ed. 2000.

  47. Terai H, Shimahara M. Tongue pain: burning mouth syndrome vs Candida- associated lesion. Oral Dis. 2007 Jul. 13(4):440-2. [Medline].

  48. Vazquez JA. Posaconazole for the management of mucosal candidiasis. Future Microbiol. 2007 Jun. 2:245-56. [Medline].

  49. Vazquez JA, Sobel JD. Mucosal candidiasis. Infect Dis Clin North Am. 2002 Dec. 16(4):793-820, v. [Medline].

White plaques are present on the buccal mucosa and the undersurface of the tongue and represent thrush. When wiped off, the plaques leave red erosive areas. Courtesy of Matthew C. Lambiase, DO.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.