Candida albicans is a naturally occurring yeast that is found in the digestive tract and mouth of most people, including babies. However, in situations in which the immune system is weakened, Candida growth can go unchecked causing a fungal infection known as candidiasis, commonly referred to as a Candida infection or a yeast infection. Candida infections are common in babies since their immune systems are not yet fully developed. Candida infections have a wide variety of manifestations in babies, from localized infection of the mouth or diaper area to more serious systemic infections that affect the internal organs.
Risk Factors and Causes
Candida infections occur when yeast has the opportunity to grow out of control unchecked. Premature babies are at especially high risk for Candida infections since their immune systems are less developed than other babies. In addition, babies who are being treated with antibiotics are at higher risk, due to the destruction of healthy bacteria that normally colonize the gut. Candida can be transmitted from mother to baby if a mother's nipples are infected with Candida. Candida in the diaper area is more common in babies who are not kept clean and dry.
Clinical Manifestations
A common manifestion of Candida infection in babies is an infection of the mouth area, known as oral thrush. According to the University of Adelaide's Mycology Online website, up to 5 percent of newborns experience oral thrush. Another common manifestation of Candida infection in babies is diaper rash, since Candida thrives in moist and warm environments. More serious infections of systemic candidiasis, in which excess Candida infects the internal organs and the blood, can affect the central nervous system, heart, eyes, bones, joints and kidneys. Systemic candidiasis, also known as the invasive form of the disease, can be fatal to infants.
Symptoms
Oral thrush causes characteristic creamy, white spots to form on the lips, tongue and inside of the cheeks that resemble cottage cheese. The spots can be scraped off, leaving a red area underneath. Thrush in the diaper area results in a red rash across the skin that is especially prominent in the folds of the skin. Symptoms of systemic Candida infection include rash, meningitis, heart murmur and kidney obstruction caused by accumulated yeast.
Diagnosis
According to BBC Health, oral thrush is usually diagnosed by looking at the characteristic spots. However, in difficult cases, a sample is scraped off for laboratory analysis. Likewise, Candida diaper rash is usually diagnosed by appearance alone. The work-up for systemic candidiasis is more complex. According to the UCSF Children's Hospital, diagnostic tests generally include cultures of the blood, urine and cerebrospinal fluid, as well as an eye exam, echocardiogram and kidney ultrasound.
Treatment
Most cases of localized candidiasis, such as oral thrush or diaper rash, will go away on their own. However, in some cases, anti-fungal medications may be prescribed. More serious cases of Candida infection are always treated with anti-fungals, which work by causing selective death to fungal cells or by interfering with their replication. According to the UCSF Children's Hospital, anti-fungals prescribed for the treatment of Candida infections include amphotericin B, flucytosine and fluconazale.
