Candida that normally lives on the skin and inside the body without causing any problems. Read more to see if you're at risk for infection.
Human tongue infected with oral candidiasis
Image by James Heilman, MD
Candida Infections
Human tongue infected with oral candidiasis
Image by James Heilman, MD
Human tongue infected with oral candidiasis
Thrush in a child who had taken antibiotics.
Image by James Heilman, MD
Candida Infections of the Mouth, Throat, and Esophagus
Candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Candida normally lives on the skin and inside the body, in places such as the mouth, throat, gut, and vagina, without causing any problems. Sometimes, Candida can multiply and cause an infection if the environment inside the mouth, throat, or esophagus changes in a way that encourages fungal growth.
Candidiasis in the mouth and throat is also called thrush or oropharyngeal candidiasis. Candidiasis in the esophagus (the tube that connects the throat to the stomach) is called esophageal candidiasis or Candida esophagitis. Esophageal candidiasis is one of the most common infections in people living with HIV/AIDS.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (6)
My Experience With Candida, "Oral Thrush"
Video by Lifey Health/YouTube
Vaginal Yeast Infection
Video by The Alurea Health Project/YouTube
Is Oral Thrush Caused by Antibiotics?
Video by The Doctors/YouTube
Oral Candidiasis
Video by The DENTI MEDS/YouTube
Candidiasis ¦ Treatment and Symptoms
Video by MainMD/YouTube
Sources of Candida Organisms
Video by Mechanisms in Medicine/YouTube
2:33
My Experience With Candida, "Oral Thrush"
Lifey Health/YouTube
4:28
Vaginal Yeast Infection
The Alurea Health Project/YouTube
1:35
Is Oral Thrush Caused by Antibiotics?
The Doctors/YouTube
8:39
Oral Candidiasis
The DENTI MEDS/YouTube
4:07
Candidiasis ¦ Treatment and Symptoms
MainMD/YouTube
7:42
Sources of Candida Organisms
Mechanisms in Medicine/YouTube
Oral Infections
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Mouth ulcer
Image by FaizSubri2017/Wikimedia
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Mouth ulcer
Image of ulcer in mouth
Image by FaizSubri2017/Wikimedia
Microbial Diseases of the Mouth and Oral Cavity: Oral Infections
As noted earlier, normal oral microbiota can cause dental and periodontal infections. However, there are number of other infections that can manifest in the oral cavity when other microbes are present.
Herpetic Gingivostomatitis
As described in Viral Infections of the Skin and Eyes, infections by herpes simplex virus type 1 (HSV-1) frequently manifest as oral herpes, also called acute herpes labialis and characterized by cold sores on the lips, mouth, or gums. HSV-1 can also cause acute herpetic gingivostomatitis, a condition that results in ulcers of the mucous membranes inside the mouth (Figure). Herpetic gingivostomatitis is normally self-limiting except in immunocompromised patients. Like oral herpes, the infection is generally diagnosed through clinical examination, but cultures or biopsies may be obtained if other signs or symptoms suggest the possibility of a different causative agent. If treatment is needed, mouthwashes or antiviral medications such as acyclovir, famciclovir, or valacyclovir may be used.
(a) This cold sore is caused by infection with herpes simplex virus type 1 (HSV-1). (b) HSV-1 can also cause acute herpetic gingivostomatitis. (credit b: modification of work by Klaus D. Peter)
Oral Thrush
The yeast Candida is part of the normal human microbiota, but overgrowths, especially of Candida albicans, can lead to infections in several parts of the body. When Candida infection develops in the oral cavity, it is called oral thrush. Oral thrush is most common in infants because they do not yet have well developed immune systems and have not acquired the robust normal microbiota that keeps Candida in check in adults. Oral thrush is also common in immunodeficient patients and is a common infection in patients with AIDS.
Oral thrush is characterized by the appearance of white patches and pseudomembranes in the mouth (Figure) and can be associated with bleeding. The infection may be treated topically with nystatin or clotrimazole oral suspensions, although systemic treatment is sometimes needed. In serious cases, systemic azoles such as fluconazole or itraconazole (for strains resistant to fluconazole), may be used. Amphotericin B can also be used if the infection is severe or if the Candida species is azole-resistant.
Overgrowth of Candida in the mouth is called thrush. It often appears as white patches. (credit: modification of work by Centers for Disease Control and Prevention)
Mumps
The viral disease mumps is an infection of the parotid glands, the largest of the three pairs of salivary glands (Figure). The causative agent is mumps virus (MuV), a paramyxovirus with an envelope that has hemagglutinin and neuraminidase spikes. A fusion protein located on the surface of the envelope helps to fuse the viral envelope to the host cell plasma membrane.
Mumps virus is transmitted through respiratory droplets or through contact with contaminated saliva, making it quite contagious so that it can lead easily to epidemics. It causes fever, muscle pain, headache, pain with chewing, loss of appetite, fatigue, and weakness. There is swelling of the salivary glands and associated pain (Figure). The virus can enter the bloodstream (viremia), allowing it to spread to the organs and the central nervous system. The infection ranges from subclinical cases to cases with serious complications, such as encephalitis, meningitis, and deafness. Inflammation of the pancreas, testes, ovaries, and breasts may also occur and cause permanent damage to those organs; despite these complications, a mumps infection rarely cause sterility.
Mumps can be recognized based on clinical signs and symptoms, and a diagnosis can be confirmed with laboratory testing. The virus can be identified using culture or molecular techniques such as RT-PCR. Serologic tests are also available, especially enzyme immunoassays that detect antibodies. There is no specific treatment for mumps, so supportive therapies are used. The most effective way to avoid infection is through vaccination. Although mumps used to be a common childhood disease, it is now rare in the United States due to vaccination with the measles, mumps, and rubella (MMR) vaccine.
This child shows the characteristic parotid swelling associated with mumps. (credit: modification of work by Centers for Disease Control and Prevention)
Source: CNX OpenStax
Additional Materials (4)
Herpes Simplex Virus (HSV-1 and HSV-2)
Video by Professor Dave Explains/YouTube
HSV 1 and 2 - Pathogenesis of Oral and Genital Herpes
Video by macrophage/YouTube
Types of Herpes
Video by Albert Einstein College of Medicine/YouTube
Oral Infections
Infections of the mouth and oral cavity can be caused by a variety of pathogens, including bacteria, viruses, and fungi. Many of these infections only affect the mouth, but some can spread and become systemic infections. The table summarizes the main characteristics of common oral infections.
Image by CNX Openstax
8:33
Herpes Simplex Virus (HSV-1 and HSV-2)
Professor Dave Explains/YouTube
2:36
HSV 1 and 2 - Pathogenesis of Oral and Genital Herpes
macrophage/YouTube
1:04
Types of Herpes
Albert Einstein College of Medicine/YouTube
Oral Infections
CNX Openstax
Symptoms
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Oral candidiasis
Image by CDC
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Oral candidiasis
This image shows Candidiasis of the mouth caused by a fungus from the genus Candida.Candidiasis is an infectious condition caused by the opportunistic fungus of the genus Candida, which includes eight species of fungi. Candidiasis is usually limited to the skin and mucous membranes.
Image by CDC
Symptoms of Oral Candidiasis
Candidiasis in the mouth and throat can have many different symptoms, including:
White patches on the inner cheeks, tongue, roof of the mouth, and throat
Redness or soreness
Cotton-like feeling in the mouth
Loss of taste
Pain while eating or swallowing
Cracking and redness at the corners of the mouth
Symptoms of candidiasis in the esophagus usually include pain when swallowing and difficulty swallowing.
Contact your healthcare provider if you have symptoms that you think are related to candidiasis in the mouth, throat, or esophagus.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
CANDIDIASIS, Causes, Signs and Symptoms, Diagnosis and Treatment.
Video by Medical Centric/YouTube
4:19
CANDIDIASIS, Causes, Signs and Symptoms, Diagnosis and Treatment.
Medical Centric/YouTube
Risk and Prevention
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Pseudomembranous candidiasis in a person with HIV
Image by Photo Credit: Sol Silverman, Jr., D.D.S.Content Providers: CDC/ Sol Silverman, Jr., DDS/Wikimedia
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Pseudomembranous candidiasis in a person with HIV
This patient presented with a secondary oral pseudomembraneous candidiasis infection. The immune system in suffers with HIV undergoes a dramatic reduction in its effectiveness, resulting in the greater possibility of secondary infections, as in this example. This infection responded to fluconazole 100 mg daily, for 1 week.
Image by Photo Credit: Sol Silverman, Jr., D.D.S.Content Providers: CDC/ Sol Silverman, Jr., DDS/Wikimedia
Oral Candidiasis - Risk and Prevention
Who gets candidiasis in the mouth or throat?
Candidiasis in the mouth, throat, or esophagus is uncommon in healthy adults. People who are at higher risk for getting candidiasis in the mouth and throat include babies, especially those younger than 1 month of age, and people with at least one of these factors:
Wear dentures
Have diabetes
Have cancer
Have HIV/AIDS
Take antibiotics or corticosteroids, including inhaled corticosteroids for conditions like asthma
Take medications that cause dry mouth or have medical conditions that cause dry mouth
Smoke
Most people who get candidiasis in the esophagus have weakened immune systems, meaning that their bodies don’t fight infections well. This includes people living with HIV/AIDS and people who have blood cancers such as leukemia and lymphoma. People who get candidiasis in the esophagus often also have candidiasis in the mouth and throat.
How can I prevent candidiasis in the mouth or throat?
Ways to help prevent candidiasis in the mouth and throat include:
Maintain good oral health
Rinse your mouth or brush your teeth after using inhaled corticosteroids
Sources
Candida normally lives in the mouth, throat, and the rest of the digestive tract without causing any problems. Sometimes, Candida can multiply and cause an infection if the environment inside the mouth, throat, or esophagus changes in a way that encourages its growth.
This can happen when:
a person’s immune system becomes weakened,
if antibiotics affect the natural balance of microbes in the body,
or for a variety of other reasons in other groups of people.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
Is Oral Thrush Caused by Antibiotics?
Video by The Doctors/YouTube
1:35
Is Oral Thrush Caused by Antibiotics?
The Doctors/YouTube
Diagnosis and Testing
Throat Culture
Image by BruceBlaus
Throat Culture
Image by BruceBlaus
Oral Candidiasis - Diagnosis and Testing
Healthcare providers can usually diagnose candidiasis in the mouth or throat simply by looking inside. Sometimes a healthcare provider will take a small sample from the mouth or throat. The sample is sent to a laboratory for testing, usually to be examined under a microscope.
Healthcare providers usually diagnose candidiasis in the esophagus by doing an endoscopy. An endoscopy is a procedure to examine the digestive tract using a tube with a light and a camera. A healthcare provider might prescribe antifungal medicine without doing an endoscopy to see if the patient’s symptoms get better.
Source: Centers for Disease Control and Prevention (CDC)
Also called: Throat culture and sensitivity, Throat swab, Oropharyngeal swab, OP swab
A throat culture, also called throat swab, is a test that is done to identify the specific type of bacteria or other germs causing the infection in your throat, so that proper treatment can be initiated.
Throat Culture
Also called: Throat culture and sensitivity, Throat swab, Oropharyngeal swab, OP swab
A throat culture, also called throat swab, is a test that is done to identify the specific type of bacteria or other germs causing the infection in your throat, so that proper treatment can be initiated.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result is normal. It means that no harmful bacteria or other germs were found in your throat secretions.
Related conditions
A throat culture is a test where a sample of pus or secretions from your throat is collected and then added to a substance that promotes germ growth.
This is useful to determine whether you have a bacterial throat infection, and if that’s the case, detect and identify the specific microorganism that is causing the infection.
This test also helps minimize the use of unnecessary antibiotic treatment, therefore reducing the chance of bacterial resistance to antibiotics (which happens when a bacteria is no longer killed by an antibiotic that has been previously used).
Your doctor may want to order this test if you have signs and symptoms of throat infection, such as:
Sore throat
Pain when swallowing
Swollen, red tonsils
Streaks of pus or white patches in your tonsils
Fever
Chills
Appetite loss
Enlarged lymph nodes in your neck
Headache
Nausea and vomiting
Neck stiffness
A sterile swab will be used to take a sample of pus or secretions from the back of your throat and tonsils, avoiding the tongue.
No test preparation is needed. You should refrain from using mouthwash before the test is done.
You may feel a little bit of discomfort, gagging sensation, or an urge to vomit or cough during the procedure, which only takes a few seconds.
The throat culture test result will come back as positive or negative.
A negative result will only report the presence of “normal respiratory flora,” or it will read something like “no growth seen in 3 days”.
A positive result will report the name the bacteria that is the causal agent of the infection.
This test is not commonly ordered to diagnose strep throat infection because results are not usually available until 24 to 48 hours later. In this case, another test called rapid antigen test is preferred.
https://medlineplus.gov/ency/article/003746.htm [accessed on Mar 03, 2019]
https://www.labcorp.com/test-menu/36296/upper-respiratory-culture-routine [accessed on Mar 03, 2019]
https://www.urmc.rochester.edu/childrens-hospital/general-peds/throat-culture.aspx [accessed on Mar 03, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=beta_hemolytic_streptococcus_culture [accessed on Mar 03, 2019]
https://www.questdiagnostics.com/testcenter/TestDetail.action?ntc=394 [accessed on Mar 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (4)
How to perform a throat swab on a patient
Video by Medscape/YouTube
Completing a Throat Culture & Rapid Strep Test
Video by Jessica Le/YouTube
Is It Strep Throat or Just a Sore Throat?
Video by Cleveland Clinic/YouTube
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Strep Throat
Strep Throat, Test Positive A case of strep throat, culture positive. A strep throat infection causes a sore throat and is spread by person to person contact. Any age group can be affected but it is most common in children aged 5 to 15.
Image by James Heilman, MD/Wikimedia
0:44
How to perform a throat swab on a patient
Medscape/YouTube
5:07
Completing a Throat Culture & Rapid Strep Test
Jessica Le/YouTube
0:39
Is It Strep Throat or Just a Sore Throat?
Cleveland Clinic/YouTube
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Strep Throat
James Heilman, MD/Wikimedia
Fungal Culture
Fungal Culture
Also called: Fungal Smear, Fungal Tests
A fungal culture test is used to find out whether you have a fungal infection, a health problem caused by exposure to fungi (more than one fungus). The test may help identify specific fungi, guide treatment, or determine if a fungal infection treatment is working.
Fungal Culture
Also called: Fungal Smear, Fungal Tests
A fungal culture test is used to find out whether you have a fungal infection, a health problem caused by exposure to fungi (more than one fungus). The test may help identify specific fungi, guide treatment, or determine if a fungal infection treatment is working.
A fungal culture test helps diagnose fungal infections. Fungal infections may happen if you are exposed to fungi (more than one fungus). Fungi are plant-like life forms, such as yeasts and molds. Fungi live everywhere:
Outdoors in air and soil and on plants
Indoors on surfaces and in the air
On your skin and inside your body
Normally, if you are healthy, fungi will not make you sick. But there are a few hundred types of fungi that can affect your health. There are two main types of fungal infections:
Superficial fungal infections affect the outside of your body, including your skin, genital area, and nails. They are very common. Usually, these fungal infections aren't serious, but they can cause itchy, scaly rashes, and other uncomfortable conditions. Examples of superficial fungal infections include:
Athlete's foot
Vaginal yeast infections
Jock itch
Ringworm, which causes a circle-shaped rash on the skin that looks like a coiled worm
Systemic fungal infections affect tissue inside your body. The fungus may grow in your lungs, blood, and other organs, including your brain. Anyone can get a systemic fungal infection, but they are less common in healthy people. In healthy people, the infection begins slowly and usually doesn't spread to other organs.
The most serious systemic fungal infections happen in people who have medical conditions that weaken the immune system or need treatment that affects the immune system. These infections tend to spread faster and affect more than one part of the body.
Examples of systemic fungal infections include:
Aspergillosis.
Histoplasmosis.
Pneumocystis pneumonia.
Sporothrix schenckii, or "rose gardener's disease," a fungus that lives in soil and on plants and enters the skin through small cuts and scrapes. It can affect the skin, lungs, joints, and nervous system.
Both superficial and systemic fungal infections can be diagnosed with a fungal culture test.
A fungal culture test is used to find out whether you have a fungal infection. The test may help identify the type of fungus that you have. The test is also used to help guide treatment and to see if treatment is working.
Your health care provider may order a fungal culture test if you have symptoms of a fungal infection. The symptoms vary depending on the type of infection. Symptoms of a superficial fungal infection include:
Red rash
Itchy, scaly, or cracked skin
Hair loss
Itching and/or discharge from the vagina (symptoms of a vaginal yeast infection)
White patches inside the mouth (symptoms of a mouth yeast infection, called thrush)
Nails that are discolored (yellow, brown, or white), thick, or brittle nails
Symptoms of a more serious, systemic fungal infection include:
Cough, chest pain, or shortness of breath
Fever
Joint and muscle aches
Headaches
Chills
Nausea and vomiting
Fatigue
Fast heartbeat
Fungi can infect different parts of the body. To do a fungal culture test you will need to provide a sample of cells or fluid from the part of your body where the fungi may be growing. The most common types of fungal tests are:
Skin or nail scraping
Used to diagnose superficial skin or nail infections
How it's done:
Your provider will use a special tool to take a small sample of your skin or nails. In certain cases, a skin biopsy may be needed.
Swab test
Used to diagnose yeast infections in your mouth or vagina. It may also be used to diagnose certain skin infections.
How it's done:
Your provider will use a special swab to gather tissue or fluid from your mouth, vagina, or from an open skin sore.
Blood Test
Used to find fungi in the blood. Blood tests are often used to diagnose more serious fungal infections.
How it's done:
A health care professional will collect a blood sample. The sample is most often taken from a vein in your arm.
Urine Test
Used to diagnose more serious infections and sometimes to help diagnose a vaginal yeast infection
How it's done:
You will collect a sterile sample of urine in a container, as instructed by your provider.
Sputum Culture
Sputum is a thick mucus that is coughed up from the lungs. It is different from spit or saliva.
Used to help diagnose fungal infections in the lungs
How it's done:
You may be asked to cough up sputum into a special container as instructed by your provider.
After your sample is collected, it will be sent to a lab for analysis. You may not get your results right away. That's because the sample usually needs time to grow so that there's enough to test. Many types of fungi grow within a day or two, and other types can take a few weeks.
You don't need any special preparations to test for a fungal infection.
There is very little risk to having any of the fungal culture tests. If a sample of your skin is taken, you may have a little bleeding or soreness at the site. If you get a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If fungi are found in your sample, it likely means you have a fungal infection. Sometimes a fungal culture can identify the specific type of fungus causing the infection. But your provider may need to order other tests to make a diagnosis.
Sometimes more testing is needed to help find the right medicine to treat your infection. These tests are called "sensitivity" or "susceptibility" tests. They check to see if which medicine will kill the fungus or stop it from growing. If you have questions about your results, talk with your provider.
If you are being treated for a fungal infection, be sure to take all your medicine as prescribed, even if you feel better. Many fungal infections clear up within a few days to weeks, but some infections require months or even years of treatment.
Fungal Culture Test: MedlinePlus Medical Test [accessed on Mar 23, 2023]
Treatment
Image of antifungal treatment
Image by Centers for Disease Control and Prevention (CDC)
Image of antifungal treatment
Image by Centers for Disease Control and Prevention (CDC)
Oral Candidiasis - Treatment
Candidiasis in the mouth, throat, or esophagus is usually treated with antifungal medicine. The treatment for mild to moderate infections in the mouth or throat is usually an antifungal medicine applied to the inside of the mouth for 7 to 14 days. These medications include clotrimazole, miconazole, or nystatin. For severe infections, the most common treatment is fluconazole (an antifungal medication) taken by mouth or through a vein. If patient does not get better after taking fluconazole, healthcare providers may prescribe a different antifungal. The treatment for candidiasis in the esophagus is usually fluconazole. Other types of prescription antifungal medicines can also be used for people who can’t take fluconazole or who don’t get better after taking fluconazole.
Source: Centers for Diseases Control and Prevention (CDC)
Additional Materials (3)
space-filling model of amphotericin b - Macrolide antifungal antibiotic produced by Streptomyces nodosus obtained from soil of the Orinoco river region of Venezuela. (NCBI/NLM)
space-filling model of amphotericin b - Macrolide antifungal antibiotic produced by Streptomyces nodosus obtained from soil of the Orinoco river region of Venezuela. (NCBI/NLM)
Image by Lanulos
Antifungal drugs target several different cell structures.
Antifungal drugs target several different cell structures. (credit right: modification of work by “Maya and Rike”/Wikimedia Commons)
Image by CNX OpenStax
Ep.1 Candida auris: A Resistant Fungal Infection | Medscape TV
Video by Medscape/YouTube
space-filling model of amphotericin b - Macrolide antifungal antibiotic produced by Streptomyces nodosus obtained from soil of the Orinoco river region of Venezuela. (NCBI/NLM)
Lanulos
Antifungal drugs target several different cell structures.
CNX OpenStax
5:24
Ep.1 Candida auris: A Resistant Fungal Infection | Medscape TV
Medscape/YouTube
Statistics
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Rhomboid glossitis
Image by Klaus D. Peter
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Rhomboid glossitis
Median rhomboid glossitis
Image by Klaus D. Peter
Candida Infections of the Mouth, Throat, and Esophagus - Statistics
The exact number of cases of candidiasis in the mouth, throat, and esophagus in the United States is difficult to determine. This is because there is no national surveillance for these infections. The risk of these infections varies based on the presence of certain underlying medical conditions. For example, candidiasis in the mouth, throat, or esophagus is uncommon in healthy adults. However, they are some of the most common infections in people living with HIV/AIDS. In one study, about one-third of patients with advanced HIV infection had candidiasis in the mouth and throat.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
Yeast Infections & Your Mouth (Beauty & Grooming Guru)
Video by Healthguru/YouTube
2:00
Yeast Infections & Your Mouth (Beauty & Grooming Guru)