A diabetic patient presents with white creamy plaques in the oral cavity that can be easily scraped off, leaving a bleeding base. Microscopy of the scraping shows pseudohyphae and budding yeast cells. What is the drug of choice for this condition?

• A Oral fluconazole
• B Oral griseofulvin
• C Topical clotrimazole cream
• D Topical nystatin suspension ✓

Explanation

Oral candidiasis (thrush) is caused by Candida albicans and presents with white, curd-like plaques that are removable, revealing an erythematous base. KOH/microscopy shows characteristic pseudohyphae and budding yeast. For uncomplicated oral thrush, topical nystatin oral suspension (swish and swallow) is the first-line treatment as it acts locally with minimal systemic absorption. Systemic fluconazole is reserved for immunocompromised patients or extensive/refractory cases. Griseofulvin is only active against dermatophytes.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.