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Neonatal candidiasis - Skin
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Neonatal candidiasis - Skin

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Contributors: Ansa Ahmed MD, Art Papier MD, Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH, Nancy Esterly MD
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Synopsis

Neonatal candidiasis can develop perinatally or postnatally: it can be acquired by passage through an infected birth canal, develop postnatally from invasive procedures or infected catheters, or be related to breaks in the skin of the neonate. It is seen after the first week of life, in contrast to congenital candidiasis, which is present at birth.
 
Affected infants may present with a varying clinical picture.

Localized disease
Localized disease is limited to the development of mucocutaneous lesions and usually presents as thrush or diaper dermatitis, but other intertriginous areas may be involved.

Systemic infection
A more widespread systemic infection occurs mostly in low birth weight infants. Cutaneous findings include diffuse erythema, vesicles, or pustules. The infant is lethargic, refuses to feed, is apneic, or is in respiratory distress. There is temperature instability and hyperglycemia. Meningitis, urinary tract infection, or candidal septicemia may occur. More severe cases may result in multi-organ failure.

Widespread cutaneous infection
The development of a widespread cutaneous candidal infection that resembles an erosive dermatitis may also be seen in extremely low birth weight infants. Risk factors for the development of this type of neonatal candidiasis include prematurity, abdominal surgery, intravenous catheterization, and broad-spectrum antibiotic use as well as steroid administration and hyperglycemia. Infants with widespread cutaneous involvement can present with macular, papular, vesicular, or pustular lesions. Erosive and ulcerative lesions develop with crust formation.

Codes

ICD10CM:
P37.5 – Neonatal candidiasis

SNOMEDCT:
414821002 – Neonatal candidiasis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Vesiculopustular rashes in the neonate may be divided into infectious, transient, or persistent dermatoses. The first goal in all vesiculopustular eruptions in the neonate is to rule out infectious etiologies.

Infectious vesiculopustular dermatoses
Transient non-infectious vesiculopustular dermatoses
Persistent non-infectious vesiculopustular dermatoses

Best Tests

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Therapy

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References

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Last Updated: 02/03/2016
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Neonatal candidiasis - Skin
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Neonatal candidiasis (Cutaneous) : Diaper area, Erythroderma, Oral white plaque, Scaly plaque, Vesicle
Clinical image of Neonatal candidiasis
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