Candida - Candidiasis Diaper Rash, Oral Thrush, Vaginal Yeast Infection
Candidiasis Diaper Rash, Oral Thrush, Vaginal Yeast Infection
Signs and Symptoms
Candidiasis is an infection caused by CANDIDA, a yeast-like fungus. Candidiasis usually affects the skin and mucous membranes (soft, moist areas around body openings, like the mouth and anus). The illness can take several different forms, each with different symptoms. The specific form of candidiasis depends on many factors, including the child's age and general health.
In healthy newborns, the most common form of candidiasis is a diaper rash. Skin in the diaper area becomes red and tender, especially inside skin folds and creases. In general, any diaper rash that lasts for three days or longer may be candidiasis.
Also in healthy newborns, candidiasis may appear as oral "thrush." In oral thrush, the CANDIDA fungus invades parts of the mouth and throat, causing cracks in the corners of the mouth and whitish or yellowish patches on the lips, tongue, palate, and inside the cheeks. When these patches are scraped or rubbed, pinpoint areas of bleeding can be seen underneath. Often, a baby with oral thrush may have no other symptoms than the patches. Sometimes the patches are painful, however, and the child has problems feeding, or is generally fussy and irritable. Newborns can develop thrush from mothers who have vaginal "yeast infections" at the time of delivery. When this happens, symptoms of oral thrush usually begin 7-10 days after birth.
Children of any age may develop CANDIDA paronychia, an infection of the skin around the nails. Fingernails are most often affected, especially in children who spend a lot of time with their hands in water. The cuticle and skin around the nails becomes swollen, red, and sometimes painful. The fingernails may grow to be abnormally shaped or colored, or may actually lift away from the skin.
Older girls and women may develop CANDIDA vulvovaginitis, an infection of the vagina and the area around the vaginal opening. This is also commonly called a vaginal "yeast infection." Symptoms include: vaginal pain, itching, or redness; a thick, white "cheesy" vaginal discharge; pain or discomfort on urination; and sometimes whitish or yellowish patches on the skin of the vaginal area (these look similar to the patches seen in the mouth of a baby with oral thrush).
Also, in both sexes, any part of the body that is constantly moist, warm, and dark can be a site of CANDIDA infection. This is especially true of skin folds in the areas of the scrotum, underarms, inner thighs, areas between fingers and toes, and the skin over the base of the spine and under the breasts (in older girls). In any one of these areas, candidiasis may appear as itchy areas of moist, crusted skin, sometimes with bright-red patches that may become infected with pus.
Candidiasis is an infection caused by one of the many species of CANDIDA - members of the group called Fungi Imperfecti. They exist in several different forms during their life spans. One form, the oval "yeast" form, is the basis for the term "yeast infection" that is sometimes used to describe candidiasis. The same species of CANDIDA that cause infections are also able to live harmlessly in places like the mouth, intestinal tract, and vagina. Of all the species, CANDIDA ALBICANS is the most common cause of candidiasis in humans.
Healthy children may develop a CANDIDA infection after being treated with antibiotics. Antibiotics kill many "harmless" bacteria that normally compete with CANDIDA for a place in the microscopic environment of areas like the mouth and vagina. When this happens, CANDIDA is free to grow without competition, and the result is often either oral thrush or a vaginal infection.
Candidiasis may affect children at different times of their lives. Up to five percent of healthy newborns, for example, may suffer from oral candidiasis (thrush) after being infected from a mother's vaginal "yeast infection" during delivery. And this same vaginal "yeast infection" is a form of candidiasis that may affect up to 75 percent of older girls after puberty.
CANDIDA infections can be very serious in premature infants and in children with cancer, HIV infection, or any weakness of the immune system. In these children, CANDIDA infection may spread through the blood to attack the lungs, brain, spleen, kidneys, and liver.
In most healthy children, candidiasis can be prevented by keeping the skin clean and dry. If an overweight child has repeated candidiasis between skin folds, weight loss and exercise may help.
To prevent CANDIDA diaper rash, change soiled or wet diapers immediately. If you use cloth diapers, rinse them several times after washing to remove traces of soap or detergent that can irritate your baby's skin. Avoid using fabric softeners - even these can be skin irritants. Some experts suggest allowing your baby to go without diapers for several hours each day to give irritated skin a chance to dry and "breathe." This is easiest when the baby can be placed in a crib that has waterproof sheets. For many parents it is more practical to buy a nonprescription diaper cream or ointment, like zinc oxide, to soothe and protect areas of skin that are prone to diaper rash.
To prevent CANDIDA infections of the fingernails, try to keep little hands from prolonged contact with water.
To prevent vaginal candidiasis, keep the vaginal area clean using unscented soap, and avoid vaginal sprays or douches. Have the child wear cotton panties, or those with a cotton crotch, since cotton doesn't trap moisture or block air circulation like nylon or polyester. After swimming, make sure your child quickly changes into dry clothing.
Although there is a variable incubation period for most forms of candidiasis, there are some useful guidelines for suspecting a CANDIDA infection. For example, newborns who develop oral thrush usually begin to have symptoms within 7-10 days after delivery. Also, a diaper rash that persists for three or more days may be a sign of CANDIDA infection.
In otherwise healthy children, most types of candidiasis are cured approximately two weeks after treatment begins.
Candidiasis is not contagious. In most healthy persons, CANDIDA already live harmlessly in many parts of the body, including the mouth, intestines, and vagina.
In otherwise healthy children, oral thrush often requires no treatment. Your doctor may suggest adding yogurt, sour cream, or buttermilk to your child's diet to help restore the correct balance of bacteria and fungi that normally live in your child's mouth. If your doctor prescribes a suspension of antifungal medication, use it as directed.
For CANDIDA diaper rash, change wet or soiled diapers frequently. Apply nonprescription ointment or cream, such as zinc oxide. If your doctor prescribes an antifungal medication with or without hydrocortisone, apply as directed.
If you suspect that your daughter has symptoms of a CANDIDA vaginal infection, and this is the first time that she has had these symptoms, call your doctor. Other types of more serious vaginal infections may have symptoms that are similar to those of CANDIDA, and your doctor may want to confirm that none of these is the cause of your daughter's discomfort. Even if your daughter has had a vaginal "yeast infection" before, it is still safest to check with your doctor before giving her any nonprescription medication for vaginal infection.
Many types of antifungal medications - including nystatin, clotrimazole, and others - are prescribed by doctors to treat the different types of CANDIDA infections. The way that the medicine is administered - by liquid, cream, or other method - depends on the area of the body that is infected.
When To Call Your pediatrician
Call your pediatrician whenever your child has any of the irritating signs or symptoms of the various forms of candidiasis. Especially important clues to watch for: irritated whitish patches inside your baby's mouth; a diaper rash that doesn't go away after three days or respond to over-the-counter soothing medications; vaginal discomfort with vaginal discharge in your young daughter; red, irritated areas inside skin folds of an obese child; red, irritated areas around the fingernails of a child who often plays in water. Remember that in a otherwise healthy child, several days of treatment with antibiotics can increase your child's risk for one of the forms of candidiasis.
If your daughter has signs and symptoms of a vaginal CANDIDA infection, check with your doctor before giving her a nonprescription medicine for "vaginal yeast infection." This is especially important if your daughter has never had these symptoms before.