Introduction:
Candidiasis is caused due to fungus in the form of yeast, molds, etc. These organisms are commonly present in the oral cavity, gastrointestinal tract, vagina, and penis. They are generally harmless and show their pathogenicity only during favorable conditions. However, it may result in rashes, itchiness, etc. Candidiasis is the third most prevalent health condition among the pediatric population. Fungal infections are highly susceptible in immuno-compromised individuals, especially those recovering from fever or chronic illnesses. Sometimes antibiotics and steroids may also result in fungal overgrowths, causing candidiasis. Antibiotics also kill the good and beneficial bacteria in the body, which are responsible for preventing fungal infections.
What Are the Other Names of Candidiasis?
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Moniliasis.
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Yeast infection.
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Thrush.
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Candidosis.
What Is the Incidence of Candidiasis?
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Candidiasis is commonly seen in infants and older people.
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37 % of newborns may be affected by Candida infection, especially during the first three months of life.
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Pregnant women are highly vulnerable to fungal infections.
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Candidiasis has no gender predilection, and it affects males and females equally.
What Are the Risk Factors?
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Hot, humid weather is highly favorable for fungal growth.
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Wet diapers or unchanged diapers for a longer duration in children.
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Poor personal hygiene.
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Patients on medications, especially antibiotics and steroids, are taken longer.
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Immunocompromised individuals or children with a weak immune system.
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Presence of systemic diseases or debilitating diseases such as HIV (human immunodeficiency virus), AIDS (acquired immunodeficiency virus syndrome), diabetes, etc.
What Are the Causes of Candidiasis?
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Candida albicans is the causative organism for candidiasis. In newborns, candidiasis may occur while passing through the birth canal or vaginal canal in the case of severe and active vaginal infections and may result in thrush formation.
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In certain children, antibiotics may result in a decreased population of beneficial bacteria causing fungal overgrowth.
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The compromised immune system is another cause of fungal infection.
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Low birth weight and preterm infants with any blood infections may also get affected by fungal infections.
What Are the Signs and Symptoms?
The symptoms vary in each child. However, the most common presentations encountered are:
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Rashes, itchiness with burning sensations.
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White patches or coatings are seen on the tongue, cheeks, etc.
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Frequent rashes are seen in the diaper areas and around the genitals.
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Poor feeding habits with fussy behavior.
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Fever with chills.
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Confusion.
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Hypotension (sudden drop in blood pressure).
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Soreness or cracking at the corners of the mouth.
What Are the Other Similar Conditions?
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Diaper rash dermatitis.
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Pediatric fungal endocarditis.
Can Candidiasis Be Prevented?
Certain home remedies, such as maintaining the child's health, may help prevent candidiasis. In addition, there are a few ways to prevent the occurrence of fungal infections in children. These include the following:
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Always keep the skin of the baby clean and dry.
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Change the diapers regularly. Wet diapers or dampness for a prolonged duration may cause fungal infections.
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Reduce diaper usage in children. Use diapers only in unavoidable situations or at night time.
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If antibiotics are prescribed for longer durations, check for any symptoms of candidal infections once the medications have been stopped.
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In case of a weak immune system, try to provide nutritious food or supplements that enhance the immune system.
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Inculcate personal hygiene in children and insist that they follow hygienic practices such as regularly washing their hands and feet after play, outside activities, etc.
What Are the Possible Complications?
Complications due to fungal infections are rare. However, they may occur in immunocompromised children. The possible complications are:
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Systemic fungal infections in newborns with low birth weight.
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Intertrigo (inflammation of the skin due to friction or skin-to-skin contact).
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Bronchopulmonary candidiasis (lower respiratory tract infection caused due to Candida species).
When to Seek Help From a Doctor?
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Take the child to a doctor if the symptoms are persistent and do not go away despite conservative treatment and home remedies.
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If the symptoms worsen and affect the health of the baby.
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If Increased swelling or redness with pus discharge is noticed, immediately take the child to a doctor.
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If further new symptoms that worsen the condition occur.
How Is Candidiasis Diagnosed?
Candidiasis may be diagnosed based on clinical findings, and no specific tests may be required to diagnose the condition. However, the tests performed are:
Laboratory Tests:
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Potassium Hydroxide Slide Test: The lesion is scraped and viewed under the microscope. It demonstrates the presence of yeast and its growth with pseudohyphae.
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Blood Culture: Although it is less inaccurate, it may still be recommended. 15 % of the children may show a positive culture.
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Urine Culture: The urine culture may be positive in patients with renal or bladder infections.
Imaging Tests:
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Ultrasound and Computed Tomography Test: Both imaging tests help to identify the spread of candidal infections in the body.
What Is the Treatment for Candidiasis?
Generally, candidiasis is a mild infection that responds well to treatment. Only in rare cases or untreated cases may it progress to severe conditions. The commonly used medications are Nystatin, Clotrimazole, Amphotericin B, and Miconazole.
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Candidal skin infections are treated with antifungal medications, creams, and gels.
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Systemic candidiasis may require intravenous or oral antifungal medications such as Caspofungin, Fluconazole, and Amphotericin B.
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Oral thrush may be treated with mouthwashes or lozenges.
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Vaginal candidiasis or candidiasis around the genitals may be treated with suppositories.
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Mild to moderate cases are initially treated with Fluconazole. In severe cases, Fluconazole is combined with liposomal Amphotericin B.
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In some instances, to prevent candidiasis in neonates, especially with lower birth weight, Fluconazole prophylaxis is started.
Conclusion:
As candidiasis is an opportunistic infection, it can be prevented by following hygienic measures. It is always better to wash the hands with soap and water or an alcohol-based hand sanitizer before attending to the baby, significantly while changing diapers, washing or wiping after bowel movements, etc. Try to change the diapers frequently in neonates and infants and keep them as dry as possible, as humid environments increase the chances of fungal infections.
