CANDIDIASIS

Reported by: Stephanie Maneje

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.
What causes thrush?
Thrush is caused by a fungus called Candida albicans. It
occurs mostly in the neonate and infant. 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/she is at an increased risk for developing
thrush.
What are the symptoms of candidiasis?
 The following are the most common 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 are (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. Consult your
child's physician for 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
 note: A mother that 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.
 in the diaper area:
 anti-fungal diaper cream
 note: 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.
TINEA INFECTION
 Tinea is the name of a group of diseases caused by a fungus.
Types of tinea include ringworm, athlete's foot and jock itch. These
infections are usually not serious, but they can be uncomfortable. You
can get them by touching an infected person, from damp surfaces such
as shower floors, or even from a pet.
(also called ringworm of the scalp) is caused by by mold-like
fungi called dermatophytes. It usually affects children and disappears
at puberty. However, it can occur at any age.
 The fungi that cause tinea infections thrive in warm, moist areas. You
have an increased risk for tinea infection if you have:
 Minor skin or scalp injuries
 Poor hygiene
 Wet skin for a long time (such as from sweating)
 Symptoms depend on the affected area of the body:
 Ringworm is a red skin rash that forms a ring around normal-
looking skin. A worm doesn't cause it.
 Scalp ringworm causes itchy, red patches on your head. It can
leave bald spots. It usually affects children.
 Athlete's foot causes itching, burning and cracked skin
between your toes.
 Jock itch causes an itchy, burning rash in your groin area.
 Areas that appear bald, due to hair that has broken off
 Itching of the scalp
 Pus-filled sores (lesions) on the scalp (kerions)
 Round, scaly lesions on the scalp that may be red or swollen
(inflamed)
 Small black dots on the scalp
 Treatment
 Anti-fungal medications, taken by mouth, are used to
treat the infection. Griseofulvin, terbinafine, and
itraconazole are often used to treat this condition.
 Keep the area clean. A medicated shampoo, such as
one containing ketoconazole or selenium sulfide, may
reduce the spread of infection. Other family members
and pets should be examined and treated, if
necessary.
 Possible Complications
 Hair loss
 Permanent scars
 Pus-filled sores (kerions)
Prevention
 Good general hygiene is important to prevent and

treat tinea infections. Shampoo the scalp regularly,

especially after haircuts.
 Avoid contact with infected pets or people. Do not

exchange headgear, combs, and similar items

unless they are first thoroughly cleaned and dried.
 Tinea Crusis
 -(jock itch) occurs on the inner aspects of the thighs
and scrotum.
 Symptoms and signs
 > itchin or a burning sensation in the groin area, thigh
skin folds, or anus. It may involve the inner thighs
and genital areas, as well as extending back to the
perineum and perianal areas .Affected areas may
appear red, tan, or brown, with flaking, rippling,
peeling, or cracking skin.
 The acute infection begins with an area in the groin
fold about a half-inch across, usually on both sides.
The area may enlarge, and other sores may develop in
no particular pattern. The rash appears as raised red
plaques (platelike areas) and scaly patches with
sharply defined borders that may blister and ooze.
Causes
 Opportunistic infections (infections that are caused by a

diminished immune system) are frequent. Fungus from

other parts of the body (commonly tinea pedis or 'athlete's
foot') can contribute to jock itch. A warm, damp
environment allowing the fungus to cultivate greatly
contributes; especially with tight, sweaty or rubbing
clothing such as a jockstrap.
Prevention
 Medical professionals suggest keeping the groin area clean

and dry by drying off thoroughly after bathing, putting on

dry clothing right away after swimming or perspiring. Not
sharing clothing or towels with others. Showering
immediately after athletic activities, wearing loose cotton
underwear, avoiding tightfitting clothes and using
antifungal powders.
 Treatment
 Tinea cruris is often treated with antifungal drugs applied
topically. Traditionally creams containing tolnaftate, Ciclopirox,
terbinafine, econazole nitrate, oxiconazole, naftifine,
clotrimazole or miconazole have been used, although newer
agents such as butenafine are also used. These anti-fungal agents
work by stopping the fungi from producing a substance called
ergosterol, which is an essential component of fungal cell
membranes. If ergosterol synthesis is completely or partially
inhibited, the cell is no longer able to construct an intact cell
membrane. This leads to death of the fungus.
 If the skin inflammation causes discomfort and itching,
glucocorticoid steroids(such as 1% hydrocortisone cream) may
be combined with the anti-fungal drug to help prevent further
irritation due to the patient scratching the area. Apart from the
quicker relief of symptoms, this also helps minimize the risk of
secondary bacterial infection caused by the scratching. However,
steroids may exacerbate the condition if used alone for fungal
infections because they hinder the body's immune system.
 Since fungi tend to thrive in warm, dark, damp conditions, minimizing
these conditions can help treat and prevent symptoms. Examples of
optimal environmental conditions and behaviors are: wearing boxer
underwear or no underwear, increasing air-flow by sleeping near a fan,
wearing loose sleepwear or no sleepwear, exposing the area to wind and
sun, and thoroughly cleaning the area with a hand-held shower head and
soap.
 Tinea pedis
 is a fungal infection of the skin that causes scaling, flaking, and itch of
affected areas
 Causes
 It is caused by fungi in the genus Trichophyton and is typically
transmitted in moist areas where people walk barefoot, such as
showers or bathhouses. Although the condition typically affects the
feet, it can spread to other areas of the body, including the groin.
Athlete's foot can be prevented by good hygiene, and is treated by a
number of pharmaceutical and other treatments.
 Signs and symptoms
 Microscopic view of athlete's foot fungus
 >scaling, flaking, and itching of the affected skin. Blisters and cracked
skin may also occur, leading to exposed raw tissue, pain, swelling, and
inflammation. Secondary bacterial infection can accompany the fungal
infection, sometimes requiring a course of oral antibiotics.
 Diagnosis
 Microscopic view of athlete's foot fungusDiagnosis & treatment can
be performed by a general practitioner or pharmacist, and by
specialists such as a dermatologist, podiatrist& to a lesser extent a
foot health practitioner
 Prevention
 The fungi that cause athlete's foot can live on shower floors, wet
towels, and footwear, and can spread from person to person from
shared contact with showers, towels, etc.
 Hygiene, therefore, plays an important role in managing an athlete's
foot infection. Since fungi thrive in moist environments, keeping feet
and footwear as dry as possible, and avoiding sharing towels, etc.,
aids prevention of primary infection.
 Treatments
 There are many conventional medications (over-the-
counter and prescription) as well as alternative
treatments for fungal skin infections, including
athlete's foot. Important with any treatment plan is the
practice of good hygiene. Several placebo controlled
studies report that good foot hygiene alone can cure
athlete's foot even without medication in 30-40% of
the cases. However, placebo-controlled trials of
allylamines and azoles for athlete’s foot consistently
produce much higher percentages of cure than
placebo