THRUSH 



311 



importance. It is known that C. albicans can be isolated from sputum 

 in many types of pulmonary disease and that it can commonly be 

 isolated from the feces. 



Thrush. Thrush is one of the commonest of the mycoses of man. 

 It is not so common or so serious nowadays as it has been in the past. 

 It is most frequently a disease of nursing infants, particularly when 

 they are undernourished or where there is a lack of cleanliness in 

 their care. In older medical literature one reads of great epidemics 

 of thrush in foundling asylums, with a relatively high mortality. AYe 

 seldom see cases in such frequency or severity now. Thrush occurs 

 also in adults, generally as a termi- 

 nal event in such wasting diseases 

 as typhoid fever, tuberculosis, or 

 cancer, especially in patients who 

 have been comatose or nearly so 

 for a long time. It also occurs fre- 

 quently as a mild infection of the 

 vagina in pregnant women. 



The majority of the cases are 

 mild, and the infection remains 

 localized to the affected mucous 

 membrane, giving rise to no symp- 

 toms save local irritation. In such 

 cases the disease appears as soft 

 whitish patches on the mucous membranes of the mouth, on the 

 tonsils, cheeks, or gums, occasionally on the tongue. These patches, 

 composed mainly of the fungus groui:h, can generally be removed 

 easily, leaving a slightly abraded surface. The membrane may be 

 mistaken for diphtheritic membrane and, judging by the frequency 

 with which this organism is found in throat cultures sent to diag- 

 nostic laboratories for examination for diphtheria bacilli, the disease 

 must be confused frequently with diphtheria. Fineman ° obtained 

 some of her strains of the thrush parasite from such cultures, and 

 Tanner and Dack investigated 22 strains of yeast-like fungi ob- 

 tained from cases of sore throat which were for the most part Candida 

 albicans. 



In some cases the disease may become chronic and spread to other 

 mucous membranes and the skin. There have been reported a small 

 number of such cases in children, in which the organisms were pres- 

 ent in the mouth over a period of some years, with occasional re- 

 peated infections, accompanied by eczematoid lesions of the skin, 

 especially in the moist parts, between the thighs, in the bends of the 



Fig. 125. 

 acteristic 



Candida albicans 

 chlamydospores 

 meal culture. 



in 



Char- 

 corn 



