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Candidiasis in Child
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Candidiasis in Child

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Contributors: Sarah Stein MD, Karen Wiss MD, Sheila Galbraith MD, Craig N. Burkhart MD, Dean Morrell MD, Lynn Garfunkel MD, Nancy Esterly MD
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Synopsis

Candidiasis refers to a variety of infections caused by Candida albicans (in 70%-80% of cases) or any of the 200 other yeast species in this genus.

The clinical presentations of candidal infection can be separated into those affecting the mucous membranes, cutaneous syndromes, and invasive candidiasis.
  • Mucous membrane infections include thrush, or oral candidiasis; candidiasis of the epiglottitis and esophagitis; and vaginal and vulvovaginal candidiasis.
  • Cutaneous candidiasis includes generalized cutaneous candidiasis, candidal intertrigo, erosio interdigitalis blastomycetica, candidal miliaria, and candidiasis of the male genitals (candidal balanitis) and perianal skin.
  • Invasive or systemic candidiasis can lead to disseminated disease and deep visceral involvement.
Mucous Membrane Infections
Thrush, or oral candidiasis, is normally seen in infants younger than 1 year or older than 12 years but can be seen in children on medications such as antibiotics or chemotherapy, in immunodeficient children, or in asthmatic patients who take inhaled steroids. The infection manifests as white plaques on the lips, tongue, and palate that bleed on superficial scraping.

Vulvovaginitis occurs commonly in pubertal and postpubertal girls and can arise due to antibiotic or corticosteroid therapy or in adolescent girls who are taking oral contraceptives. Patients complain of pruritus and discharge along with dysuria and dyspareunia in sexually active girls.

Cutaneous Candidiasis

Generalized cutaneous candidiasis appears as deep red skin that is edematous and oozing fluid. Crusting and pustular lesions are present as "satellite" lesions. The presence of plaque formation may cause this condition to resemble psoriasis. Infected skin may be localized or widespread, and sometimes the scalp may be affected with resultant hair loss.

Diaper Dermatitis
Candidal diaper dermatitis develops when sufficient moisture in the diaper area allows C. albicans to proliferate and invade the stratum corneum. Children may experience burning on micturition.

Intertrigo
This form of candidiasis is more prevalent in obese or diabetic children. Intertrigo commonly occurs in the axillary region, intergluteal cleft, inguinal folds, and other body folds. Patients frequently feel itchy in these areas. Predisposing factors include moisture, heat and maceration, obesity, and tightly fitting clothing. The skin presents with red erythematous macules with surrounding satellite lesions.

Erosio Interdigitalis Blastomycetica
In erosio interdigitalis blastomycetica, children may develop candidal infection of the web spaces of their fingers or toes if they are constantly moist or remain immersed in water for a long period of time.

Candidal Folliculitis
Folliculitis is infection of the hair follicles. Although usually localized, it may become widespread and must be differentiated from folliculitis caused by dermatophytes and tinea versicolor.

Male Genital Candidal Infection
Genital candidal infection in boys can manifest as either balanitis or as erythema of the scrotal area or penile shaft.

Mucocutaneous Candidiasis
Mucocutaneous candidiasis is a genetic syndrome linked to defective cell-mediated immunity to Candida antigens in which children experience recurring candidal infections. Chronic skin lesions appear as hyperkeratotic crusted lesions and nail dystrophy. The affected nails are thickened, brittle, and yellow-brown in color and have associated paronychia. Most cases develop in childhood and adolescence.

Systemic or Invasive Candidiasis

See Candida sepsis.

Nail
For nail involvement, see paronychia and onychomycosis.

Codes

ICD10CM:
B37.2 – Candidiasis of skin and nail

SNOMEDCT:
78048006 – Candidiasis

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 09/15/2017
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Candidiasis in Child
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Candidiasis : Burning skin sensation, Erythema, Inframammary fold of chest, Macerated skin, Inguinal region, Pustules
Clinical image of Candidiasis
Erosio interdigitalis blastomycetica showing a macerated and eroded plaque at the finger web.
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