Symptoms of candidiasis in children

The most frequent form of candidal infection is thrush. Most often it is observed in newborns and young children, especially in weakened or having other diseases, with long-term antibiotic treatment. The main symptom of the disease is curdled white on the mucous membrane of the cheeks, gums, soft and hard palate. First the overlays are dotted, then they merge. Overlays can be easily removed. In advanced cases, the overlays become dense, acquire a greyish-dirty color, are removed with difficulty, after their removal, the mucous membrane may bleed. In children of the first days of life, not burdened by any diseases, when the thrush occurs, the general condition is not significantly disturbed. In attenuated children thrush can take a prolonged chronic course, with white overlays spreading along the edge of the gums, on the soft and hard palate, the mucous membranes of the cheeks and tongue.

When the mucous membrane of the tongue is affected, in addition to the fungal overlays, the areas lacking papillae are visible. The tongue is edematous, with focal hyperemia and striation of longitudinal and transverse furrows.

• Candidiasis as an isolated lesion is rare, it usually occurs against a background of candidiasis of the oral mucosa. In this case, on the surface of the tonsils, sometimes on the shackles, loose loose whitish island or solid overlays, easily removed by a spatula. The tissue of the tonsils is little changed. There is no hyperemia of the mucous membranes of throat and the reaction of regional lymph nodes. The general state of children is not significantly disturbed. Body temperature remains within normal limits.
• Candidiasis of the corners of the mouth (zaida): in the corner of the mouth there are cracks and erosion with perifocal infiltration. The lesion is usually bilateral. To differentiate follows with a streptococcal gall, at which the inflammatory reaction is more expressed.
• Halit: red lip rim is hyperemic, edematous, striated by radial striae. Patients complain of burning and dry lips. The course of the disease is long. Differentiate with the cheilitis of another etiology.
• Candidiasis vulvovaginitis is characterized by secretions of white color. On the mildly hyperemic mucous membrane of the genital organs, whitish or gray, loose curdled overlays are found, less often - superficial erosions. Overlays can be on the mucous membrane of the vagina and cervix. Patients complain of severe itching and burning in the area of the external genitalia.
• Intertriginoznye candidiasis in the area of large folds of the skin is more often observed in infants. You can notice maceration of the stratum corneum on the background of hyperemic or erosive skin. The folds in the area of the anus, the genital organs, in the inguinal and femoral zones, behind the ears, on the neck, face, eyelids, around the mouth are affected.
• Candidiasis erosions differ from banal intertrigoids in dark red color and lacquer gloss, wet (but not wetting) surface, distinct, non-diffuse borders with scalloped edges, narrow peripheral border of thin white macerated horny layer of skin. From the folds, the process can spread to smooth skin, and in severe cases and the entire skin. Such forms of fungal lesions should be differentiated with streptococcal or streptofrostococcal intertrigo, desquamative erythrodermia of infants (Leiner eritrodermy) and exfoliative dermatitis of newborns (Ritter's disease).
• Candidiasis of smooth skin in infants is usually the result of the spread of intertriginous candidiasis from the skin folds, as well as the defeat of the skin soles.
• Candidiasis of the skin of the scalp, as well as candidiasis of nail ridges and nails, in children may occur in the case of chronic generalized granulomatous candidiasis.
• Chronic generalized granulomatous candidiasis occurs in persons with reduced nutrition, suffering from gastrointestinal upset or bronchitis. The disease begins in childhood with persistent thrush of the oral cavity. In the future, the process spreads: there are cheilitis, glossitis, seizures, poorly amenable to therapy. Many people are diagnosed with deep tooth decay.

Nails and nails are almost constantly affected. Large subcutaneous nodes may appear, which, gradually softening, are opened, forming long non-healing fistulas. The appearance of such nodes and tubercle rash at various sites indicates a hematogenous distribution of the fungus of the genus Candida.

• Candidiasis of the lungs is currently one of the most frequent manifestations of visceral candidiasis resulting from prolonged non-rational antibiotic therapy.

The course can be acute, prolonged or chronic, with relapses, exacerbations. Abscessed and cavernous forms of candidiasis pneumonia, pleurisy, which are clinically and radiological difficult to differentiate from tuberculosis, are described. Especially unfavorable is the course of candidiasis pneumonia and other candidiasis in children who are allergic. In these cases, candidiasis of the lungs can proceed according to the type of bronchial asthma. To establish the diagnosis of Candida pneumonia, the appearance of pneumonia in the treatment of antibiotics of any disease, the occurrence of thrush, seizure, intertriginozny dermatitis, deterioration of the condition, despite antibiotic therapy should be taken into account. Note the hectic body temperature, lymphopenia, normal or increased number of leukocytes, increased ESR.

Laboratory methods of investigation (re-detection of fungus in sputum and positive serological responses), together with the clinical picture, provide the basis for the diagnosis of candidal pneumonia. Improvement of the patient's condition after the abolition of antibiotic therapy is also important to consider when diagnosing this disease.

• Candidiasis of the digestive tract. Abundant, solid fungal overlays can cover the entire mucosa of the esophagus. Clinically, progressive dysphagia and the inability to swallow food are noted.
• Candidiasis of the stomach is diagnosed only with histological examination. On the affected part of the stomach, there is hyperemia of the mucosa and small erosions; typical thrush overlays are rarely observed.
• Candidiasis of the intestine is manifested by symptoms of enterocolitis or colitis; bloating, intestinal colic, watery stool, sometimes with an admixture of blood. The course is usually long, relapsing. Morphological examination of the deceased from generalized forms of candidiasis in the intestine reveals multiple ulcers, sometimes with perforation and development of peritonitis.
• Urinary tract infection - urethritis, cystitis, pyelitis, nephritis - can be the result of an ascending candidal infection or may be a hematogenous pathway (with sepsis).
• Generalized candidiasis. Patients may develop candidal endocarditis with cardiac valve disease or candidal meningitis and meningoencephalitis (mainly in young children). Candidiasis meningitis is accompanied by mild meningeal symptoms, a slight increase in body temperature, a sluggish torpid flow with a very slow sanation of cerebrospinal fluid. Relapses are frequent. Isolation of yeast-like fungi of the genus Candida from cerebrospinal fluid confirms the diagnosis.
• Candida sepsis is the most severe manifestation of candidal infection. Usually, candidal sepsis is preceded by another severe disease or microbial sepsis, which is complicated by the superinfection of the Candida fungus .

Candidiasis can spread directly over the mucous membrane of the mouth to the esophagus, intestine or larynx, bronchi and lungs and result in sepsis. It is also possible to spread the fungus of the genus Candida from the mucous membrane of the mouth with a hematogenous route. However, in any case, the initial clinical form of candidiasis, leading to candidal sepsis in newborns, is thrush of the mouth, esophagus or lungs.

[1], [2], [3], [4]