[Dysphagia] Oral thrush

[drolfe at nsccahs.health.nsw.gov.au (Deanna Rolfe)]

Could oral thrush cause dysphonia (assuming that it is in the larynx too...hasn't been visualized)??

I have a patient who has very bad oral thrush, who says its like swallowing razor blades, who has lost his voice also in the last couple of days (intermittent aphonia, but voicing is very breathy when achieved).

He has lung cancer, so the thought also crossed my mind that there may be some other nasty involved in the voice loss, but wondered about the thrush first.

Deanna
Australia

>>> "Pressman, Hilda" <pressmah@sjhmc.org> 19/04/2006 12:20:30 am >>>
Thrush looks like curdled milk.  It is related to immune suppression but can even occur in individuals who have only been on antibiotic.  It can be quite painful.  In the mouth I have seen it on the tongue, palate and gums.  It can also be present in the esophagus and can cause painful swallowing.  It is responsive to meds, however the esophageal thrush takes much longer to clear up than the oral thrush.  Hilda Pressman MA, CCC SLP BRS-S

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On 
Behalf Of TERRY W. BAGGS
Sent: Wednesday, April 12, 2006 9:50 AM
To: Paula leslie; Alexandra Mitchell; dysphagia
Subject: RE: [Dysphagia] Oral thrush


I find that most new folks (students, CFs, etc) tend to confuse simple
oral gunk with thrush.  A pretty good way to tell the difference is to
try to remove it.  Oral gunk will come off.  Thrush will not.  I always
go to the nurse in charge of that patient.  Oftentimes, they're so busy
with other things, they have no clue about the thrush.



-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On
Behalf Of Paula leslie
Sent: Wednesday, April 12, 2006 1:29 AM
To: Alexandra Mitchell; dysphagia
Subject: RE: [Dysphagia] Oral thrush

Hi Alexandra

I'm not the best oral examiner in the world so I probably over estimate
but 
these look like many of the mouths I see on the wards.  I am obsessed
about 
oral hygiene.  If in doubt I always mention it to the nurse or HCA,
often 
gently like "is this person receiving any treatment for an oral
infection?"  
to find out if the med team already know. If they do that's great and
then I 
go on about oral health and chest infections (ad nauseam... does get the

message through), and how painful mouths affect eating and swallowing.
So how 
great it is that they're treating it.

If they aren't treating then I ask them to come and have a look and "oh
is 
that thrush etc?" Then I go on about oral hygiene and chests..... you
know.  
So - get it treated.  If it's bad enough I'll say that they might want
to 
consider non-oral supplementation because the pt is never going to
manage 
adequate hydration and nutrition orally.

But cases differ, most of mine are elderly care, H&N is different, Ca is

different.  If any hint of it then do mention it, it's up to the med
team to 
decide what to do, but you can give them some info on oral hygiene,
chests, 
hydration and nutrition etc that will help inform their decision.

And some lovely pictures for (UK) breakfast time!

Good Luck!

Paula



http://www.lib.uiowa.edu/hardin/md/dermnet/thrush.html 

http://images.google.com/imgres?imgurl=http://www.lib.uiowa.edu/hardin/m 
d/pictures22/cdc/PHIL_2925_lores.jpg&imgrefurl=http://www.lib.uiowa.edu/
hardin/md/cdc/2925.html&h=476&w=700&sz=24&tbnid=ViT9RpqPxz_10M:&tbnh=93&
tbnw=138&hl=en&start=5&prev=/images%3Fq%3D%2Boral%2Bcandida%26svnum%3D10
%26hl%3Den%26lr%3D%26rls%3DRNWE,RNWE:2005-51,RNWE:en>===== Original
Message From Alexandra Mitchell <pawprint1980@yahoo.com.au> 
=====
>Hello everyone,
>
>  I am fairly new to speech pathology and I was wondering if someone
could 
inform me about:
>
>   What oral thrush looks like and
>   When it is significant/severe enough to inform the medical team that
they 
need to do something about the amount etc
>  Thanks so much for any information
>
>  Alexandra

Paula Leslie
Degree Programme Director
RCSLT Specialist Advisor in Dysphagia

Surgical and Reproductive Sciences
Faculty of Medical Sciences
University of Newcastle
Newcastle upon Tyne
NE2 4HH
UK
+44 (0) 191 222 6279(T)/8988(F)
http://www.ncl.ac.uk/sars/postgrad/MSc.htm 

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