What is candidiasis or thrush?

Candidiasis (sometimes called moniliasis or a yeast infection) is an infection caused by yeast on the skin and mucous membranes. When the infection occurs in the mouth, it is called thrush. If an infant has thrush, there is a chance that the infant also has a yeast infection in the diaper area.

A mother who is breastfeeding may also need to be treated if she has a fungal infection on her breasts. This will help decrease the chance of re-infecting the infant.

What causes thrush?

Thrush is caused by a fungus called Candida albicans. It occurs commonly in the neonate and infant. Older children with thrush often have another health problem that causes the condition to develop. The following are some of the factors that may increase the chance of the infant developing thrush:

• Antibiotics. Antibiotics can cause yeast to grow, because the normal bacteria in tissues are killed off, letting the yeast grow unhampered.
• Steroids. Steroids may decrease the child's immune system and decrease the ability to fight normal infections.
• Poor immune system. If the infant has a poor immune system and an inability to fight infection from another chronic disease, he or she is at an increased risk for developing thrush.

What are the signs and symptoms of candidiasis?

The following are the most common signs and symptoms of candidiasis. However, each child may experience symptoms differently. Symptoms may include:

• In the mouth (thrush):
  • The tongue becomes white
  • White patches on the cheeks or throat (these white lesions do not scrape off easily)
• In the diaper area:
  • Very red lesions with well-defined edges (lesions may be raised)
  • Sores that have pus in them

Yeast infections in the diaper area usually have additional lesions away from the diaper area (i.e., on the stomach or thighs). A boy's scrotum may also be affected.

The symptoms of candidiasis may resemble other dermatologic conditions or medical problems. Always consult your child's physician for a diagnosis.

How is candidiasis diagnosed?

The diagnosis of candidiasis is made by your child's physician after a thorough history and physical examination. After examining the lesions, the physician may perform cultures of the lesions to help verify the diagnosis and to help in selecting the best treatment.

Treatment for candidiasis

Candidiasis is highly treatable with medicated ointments and other interventions. Treatment depends on the site of the infection. Specific treatment will be determined by your child's physician based on:

• Your child's age, overall health, and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Treatment may include:

• In the mouth (thrush):
  • Anti-fungal medication that is applied on the lesions in the mouth
  • Oral anti-fungal medication

• In the diaper area use an anti-fungal diaper cream

  Keep your child's diaper area clean and dry. Let your child's bottom be exposed to air for approximately 15 minutes, several times throughout the day.

A mother who is breastfeeding may also need to be treated if she has a fungal infection on her breasts. This will help decrease the chance of re-infecting the infant.