Candidiasis (candidiasis, thrush) in children

Candidiasis in children (candidiasis, candidamycosis, thrush) is a disease caused by yeast-like fungi of the genus Candida. Fungi of the genus Candida can affect all mucous membranes, skin, nail ridges, nails, can spread by hematogenous way, causing damage to various organs and systems (candidacepsis).

ICD-10 code

• 837.0 Thrush of thrush (thrush).
• 837.1 Pulmonary candidiasis.
• 837.2 Candidiasis of skin and nails.
• Candidiasis of the vulva and vagina.
• 837.4 Candidiasis of other urogenital localizations.
• 837.5 Candidial meningitis.
• 837.6 Candidiasis endocarditis.
• 837.7 Candida septicemia.
• 837.8 Candidiasis of other localizations (enteritis, cheilitis).
• 837.9 Unspecified candidiasis.

Epidemiology of candidiasis in children

Candidiasis are widespread both in humans and in animals. Especially often, the disease occurs in newborns and young children, as well as in weakened and malnourished children.

Infection is transmitted more often by contact, less often - by airborne and through infected care items. Infection of newborn fungi of the genus Candida occurs in most cases during labor. The child can also get infected from the mother with candidiasis of the nipples (cracks), skin of the mammary glands, etc. It is possible to transfer the milkweed to the newborn through the care of the nursing staff and the care items. There are epidemic outbreaks of skin candidiasis in maternity hospitals, as well as in young children in orphanages and families.

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

Causes of Candidiasis in Children

The genus Candida includes 30 species with 6 variants. Yeast-like fungi grow under aerobic conditions, refer to opportunistic microorganisms. Transfer multiple freezing, retain viability in the dried state for several years. At boiling die almost instantly. Common disinfectant solutions kill them within a few minutes.

[5], [6], [7], [8], [9]

Pathogenesis of candidiasis in children

Infection can occur both exogenous and endogenous.

Candidiasis of the mucous membrane of the oral cavity and skin is more often detected in newborns, and especially in premature infants, which is explained by the weakness of general and local defense mechanisms. The process easily spreads to neighboring tissues and organs, there is a generalized candidiasis infection with internal organs. Artificial feeding of newborns also contributes to the emergence and more severe course of candidiasis.

Causes and pathogenesis of candidiasis (thrush)

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.

Symptoms of candidiasis (thrush)

Classification of candidal infection

The clinical picture distinguishes:

1. Candidiasis of the mucous membranes (oral cavity, gum, tongue, tonsils, throat, larynx, trachea, corners of mouth - zaida, red border of lips - cheilitis, teeth - candidiasis caries, vulva and vagina).
2. Candidiasis of the skin and its appendages.
   • Candidiasis intertriginous (candidiasis of large and small skin folds, glans penis and prepuce bag - balanoposthitis).
   • Candidiasis of smooth skin (outside folds).
   • Candidiasis of the skin of the scalp.
   • Candidiasis of nail ridges and nails.
3. Candidiasis visceral, systemic:
   • Candidiasis chronic generalized granulomatous.
   • Candidiasis of the bronchi, lungs, pleura, gastrointestinal tract, urinary tract, eye, ear, candidal sepsis.
4. Allergic manifestations in candidiasis.

[10], [11], [12], [13], [14], [15], [16]

Diagnosis of candidiasis in children

Diagnosis of candidiasis is established on the basis of white cheesy overlays (candidiasis of the mucous membranes) or typical dark red foci with clear boundaries with erosized or macerated horny layer (candidiasis of the skin). In visceral candidiasis, clinical diagnosis is very difficult and often becomes possible only after obtaining the results of a laboratory study. Determining the fungus of the genus Candida by the PCR method is crucial . From other laboratory methods, the study of pathological material (scales, crusts from the skin, pus, sputum, blood, urine, bowel movements, vomit, bile, pieces of biopsy tissue, cadaver material) is directly important under the microscope, as well as culture studies. Pathological material intended for inoculation is preliminarily treated with a mixture of various antibiotics and inoculated on Saburo and others. For serological studies, RA, RPGA, RIF, and also enzyme immunoassay are used.

When histological examination of cadaveric material or a biopsy specimen, a PAS-color is used to detect fungi.

[17], [18], [19], [20], [21]

Treatment of candidiasis in children

With local lesions of the mucous membranes and skin can be limited to the use of antifungal drugs in the form of ointments, cream or solutions. The lesions are treated with 1-2% aqueous solution of brilliant green. Fucorcin (Castellani liquid), myco-septin, exoderil and other antifungal ointments (triderm, acryderm, terbinafine). The effect of 5% cycloferon liniment is shown. 5-10% solutions of borax in glycerol (INN: sodium tetraborate), 1% iodolipol solution, 5-10% tannin solution, clotrimazole solution, etc. Are used for irrigation of the oral cavity. The use of drugs, especially in the treatment of candidiasis of the oral mucosa, possessing a vaccine-like action - imudon in tablets for resorption, containing in its composition including lysate of fungi of the genus Candida.

Treatment of candidiasis (thrush)

Prophylaxis of candidiasis in children

In the system of preventive measures, the rational use of antibacterial drugs, especially antibiotics, is of great importance. With prolonged use of antibiotics for the prevention of candidal infection should be prescribed antifungal drugs. It is necessary to avoid contact of newborns and young children with people with signs of candidal infection. Essential importance is the correct diet, vitamin supply, hygienic skin care, mucous membranes, strengthening the health of children and adults.

Specific prophylaxis of candidal infection has not been developed.

Forecast

In most cases, favorable. Thrush and other superficial forms of candidal infection are quickly cured. In generalized forms, the prognosis is serious, depends on the course of the underlying disease, against which the candidiasis infection developed.

[22]