Candida infection (candidiasis, thrush) in children

Candidal infection in children (candidiasis, candidiasis, thrush) is a disease caused by yeast-like fungi of the genus Candida. Fungi of the genus Candida are capable of affecting all mucous membranes, skin, nail folds, nails, and can spread hematogenously, causing damage to various organs and systems (candida sepsis).

ICD-10 code

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

Epidemiology of candidiasis in children

Candidiasis is widespread in both humans and animals. The disease is especially common in newborns and young children, as well as in weakened and emaciated children.

The infection is transmitted most often by contact, less often by airborne droplets and through infected care items. Infection of newborns with Candida fungi occurs in most cases during childbirth. The child can also become infected from the mother with candidiasis of the nipples (cracks), skin of the mammary glands, etc. Thrush can be transmitted to newborns through the hands of nursing staff and care items. Epidemic outbreaks of skin candidiasis are known in maternity hospitals, as well as in young children in orphanages and families.

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Causes of Candidiasis in Children

The genus Candida includes 30 species with 6 variants. Yeast-like fungi grow in aerobic conditions and are considered opportunistic microorganisms. They tolerate repeated freezing and remain viable in a dried state for several years. They die almost instantly when boiled. Common disinfectant solutions kill them within a few minutes.

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Pathogenesis of candidiasis in children

Infection can occur both exogenously and endogenously.

Candidiasis of the oral mucosa and skin is more often detected in newborns, and especially in premature babies, which can be explained by the weakness of general and local defense mechanisms. The process easily spreads to neighboring tissues and organs, causing a generalized candidal infection with damage to internal organs. Artificial feeding of newborns also contributes to the occurrence and more severe course of candidiasis.

Causes and pathogenesis of candidiasis (thrush)

Symptoms of Candidiasis in Children

The most common form of candidal infection is thrush. It is most often observed in newborns and young children, especially in weakened or having other diseases, in those treated with antibiotics for a long time. The main symptom of the disease is cheesy white deposits on the mucous membrane of the cheeks, gums, soft and hard palate. At first, the deposits are point-like, then they merge. The deposits are easily removed. In advanced cases, the deposits become dense, acquire a grayish-dirty color, are difficult to remove, after their removal, the mucous membrane may bleed. In children in the first days of life, not burdened by any diseases, the general condition is not noticeably disturbed when thrush occurs. In weakened children, thrush can take a long-term chronic course, with white deposits spreading along the edge of the gums, to the soft and hard palate, mucous membranes of the cheeks and tongue.

Symptoms of Candidiasis (Thrush)

Classification of Candidal Infection

According to the clinical picture, the following are distinguished:

1. Candidiasis of the mucous membranes (oral cavity, gums, tongue, tonsils, pharynx, larynx, trachea, corners of the mouth - angular cheilitis, red border of the lips - cheilitis, teeth - candidal caries, vulva and vagina).
2. Candidiasis of the skin and its appendages.
   • Intertriginous candidiasis (candidiasis of large and small skin folds, the head of the penis and the preputial sac - balanoposthitis).
   • Candidiasis of smooth skin (outside folds).
   • Candidiasis of the scalp.
   • Candidiasis of the nail folds and nails.
3. Visceral and systemic candidiasis:
   • Chronic generalized granulomatous candidiasis.
   • Candidiasis of the bronchi, lungs, pleura, gastrointestinal tract, urinary tract, eyes, ears, candidal sepsis.
4. Allergic manifestations in candidiasis.

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Diagnosis of candidiasis in children

The diagnosis of candidiasis is established on the basis of white cheesy deposits (candidiasis of the mucous membranes) or typical dark red lesions with clear boundaries with an eroded or macerated stratum corneum (candidiasis of the skin). In visceral candidiasis, clinical diagnosis can be very difficult and often becomes possible only after receiving the results of a laboratory study. Of decisive importance is the detection of the Candida fungus by the PCR method. Of other laboratory methods, the study of pathological material (scales, crusts from the skin, pus, sputum, blood, urine, feces, vomit, bile, pieces of biopsied tissue, cadaveric material) directly under a microscope, as well as cultural studies, remain important. Pathological material intended for sowing is pre-treated with a mixture of various antibiotics and inoculated onto Sabouraud's medium, etc. For serological studies, RA, RPGA, RIF, and enzyme immunoassay are used.

In histological examination of cadaveric material or biopsy, PAS staining is used to identify fungi.

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Treatment of candidiasis in children

In case of local lesions of the mucous membranes and skin, it is possible to limit the use of antifungal drugs in the form of ointments, creams or solutions. The lesions are treated with a 1-2% aqueous solution of brilliant green, fucorcin (Castellani liquid), mycoseptin, exoderil and other antifungal ointments (triderm, akriderm, terbinafine). The effect of using 5% cycloferon liniment has been shown. For irrigation of the oral cavity, 5-10% solutions of borax in glycerin (INN: sodium tetraborate), 1% solution of iodolipol, 5-10% solution of tannin, clotrimazole solution, etc. are used. Of particular importance in the therapy of candidiasis of the oral mucosa is the use of drugs with a vaccine-like effect - imudon in lozenges, which contains in its composition, among other things, a lysate of fungi of the genus Candida.

Treatment of candidiasis (thrush)

Prevention of candidiasis in children

In the system of preventive measures, the rational use of antibacterial drugs, especially antibiotics, is of great importance. With long-term use of antibiotics for the prevention of candidal infection, antifungal drugs should be prescribed. It is necessary to avoid contact of newborns and young children with people who have signs of candidal infection. The correct diet, provision of vitamins, hygienic care of the skin, mucous membranes, strengthening the health of children and adults are of great importance.

Specific prevention 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, depending on the course of the underlying disease, against which the candidal infection developed.

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