Fungal infection in children - candidiasis (thrush)

Causes of stomatitis

In children, as in adults, stomatitis can be caused by viruses, fungi, bacteria, allergies and injuries. About six months after birth, the child loses the immunity received from the mother, the protective power of the immune system changes, and the child’s body becomes more susceptible to infections. The oral mucosa in children is more delicate and easier to injure; children also more often “bite” their cheeks after dental treatment due to a temporary loss of sensitivity after anesthesia, which causes traumatic stomatitis.

Children are not always motivated to brush their teeth, so poor hygiene can also cause stomatitis.

With the following diseases, stomatitis is observed in children much more often: chronic tonsillitis, diabetes mellitus, heart defects, chronic hepatitis.

Reasons for appearance

Candidiasis is often transmitted to a child from adults; according to statistics, 70% of people are infected with thrush and are its carriers. The disease can be transmitted in different ways, from treating the navel to kissing a baby. The main causes of the disease in children:

• during contact between an adult and a child;
• when processing the umbilical cord in a newborn;
• during breastfeeding;
• through the birth canal;
• through household items (toys, linen, etc.).

White plaque on the lips of a baby

A white film on the tongue of newborns in the period from 0 to 1.5 months is common; the palate, mouth or lips may turn white after milk, because The baby's saliva production is still low. But when whitish spots do not go away, roll into lumps, a layer of white plaque appears on the tongue, in the mouth and on the cheeks, it can be said that the baby has candidiasis.

Thrush in a newborn can be observed both during consumption of breast milk and during artificial feeding. Nursing mothers with thrush must maintain strict hygiene, otherwise the fungus will be transmitted to the baby through the nipple. If a newborn is fed artificial formula, then you need to pay attention to the amount of sugar in the composition, the candida fungus actively develops when its content is high.

Classification of HRAS (chronic recurrent aphthous stomatitis)

All types of stomatitis occur in children, but the most common are: herpetic, candidal and traumatic stomatitis.

Acute herpetic stomatitis

It occurs most often, and mainly affects children from 10 months to 3 years.3 The appearance of rashes is preceded by inflammation of the lymph nodes.

With a mild form

In acute herpetic stomatitis, the temperature rises to 37-37.5°C, the general condition is satisfactory, slight swelling and redness may occur on the gums, then up to six blisters appear, which burst with the formation of painful aphthae surrounded by a red rim.
Afta is a round-shaped erosion. Aphthae may merge together. The rash appears once, and after 1-2 days the erosion gradually heals.

Moderate form

Acute herpetic stomatitis is characterized by deterioration of the child’s well-being, weakness, and headache. The child is capricious, has no appetite, the lymph nodes are enlarged and painful, the temperature rises to 38-39°C, the symptoms resemble ARVI. The oral mucosa is swollen, reddened, rashes appear (bubbles, then erosions) of 10-15 pieces, and often there are rashes on the face. Salivation increases, and gingivitis appears (inflammation of the gums, accompanied by bleeding). The rash may appear several times, i.e. after the old ones heal, new ones appear. Healing of erosions takes up to 4-5 days. Bleeding gums and swollen lymph nodes persist for some time after the erosions have healed.

Severe form

It begins as an acute respiratory viral infection, there is pain in the muscles, joints, tachycardia and bradycardia (increased and slow heartbeat), and nosebleeds may even be observed. In this form, the temperature is high up to 40°C, gingivitis is pronounced, the mucous membrane is bright red, swollen, the child’s lips are dry, the mucous membrane of the eyes is swollen, reddened. The rashes constantly appear again, their number can reach 100. Rashes often appear around the mouth, on the eyelids, on the mucous membranes of the eyes, between the fingers, on the earlobes. Simple gingivitis turns into ulcerative (a more severe form of gum inflammation, with the formation of ulcers), salivation increases, and bad breath appears. Recovery is long and hospitalization is often required.

Self-medication precautions

When choosing methods for self-treatment of oral thrush in a baby, you need to understand that sometimes such procedures may not correct the situation, but on the contrary, harm the child.

For example, improper use of soda solution when treating the oral mucosa can cause additional injuries. Therefore, carefully prepare the soda solution, not exceeding its concentration more than 1-2%, because a stronger concentration leads to a burn to the mucous membrane.

You can complicate the situation with candidiasis by using a honey solution. After all, beekeeping products are one of the most powerful allergens, so when using them you need to be absolutely sure that there is no allergic reaction.

In addition, when using herbal infusions, do not use several herbs at the same time. In this case, if an allergy suddenly arises, you will know which plant caused it.

Similar folk recipes can be used when treating an older child, but it is better not to experiment with the baby’s health. If the situation is urgent and you cannot see a doctor today, it’s better to play it safe and call an ambulance. At your appointment at the clinic, your doctor will prescribe medications to combat the fungal infection. When treated with medications, you can avoid additional risks, and candidiasis will go away faster.

Enteroviral vesicular stomatitis (arm - leg - mouth)

Caused by enteroviruses. It also occurs in adults, but in 95.7% of cases children are affected.6 It is characterized by seasonal occurrence (summer - autumn) and group incidence.4 It is observed mainly in children under 10 years of age. Vesicular stomatitis is contagious, so it is recommended to use separate utensils and hygiene products. Characteristics for this disease: temperature 37.5-38, weakness, headache, muscle pain, rash on the palms, soles, as well as blisters on the hard palate and pharynx, which then turn into erosions that are almost not painful.

Acute pseudomembranous candidal stomatitis (thrush)

Acute pseudomembranous candidal stomatitis (thrush) occurs:

• Light shape
• Medium-heavy forms
• Severe form

The main symptom of the disease is a white or yellow coating.

With a mild form

The plaque is located in islands, most often on the tongue and cheeks. Children are restless, sleep poorly, and suck the breast sluggishly. Older children may complain of a burning sensation. The plaque is easily removed; underneath there is a bright red mucous membrane. The disease lasts no longer than 7 days.5

Moderate form

The plaque is located on the cheeks, tongue, hard palate, and mucous membranes of the lips. Under the plaque, erosions form, which sometimes bleed. The plaque is more difficult to remove. Lymph nodes are sometimes enlarged and painful. The duration of the disease is 10-15 days, there are relapses.

Moderate form

The plaque is dirty gray, almost cannot be removed, and is located on the tongue, cheeks, soft palate, tonsils, pharynx, and mucous membranes of the lips. Cheilitis appears in the corners of the mouth - inflammation of the lips. The oral mucosa is dry and inflamed. The child’s health is impaired, the child refuses to eat, and the temperature rises. Lesions in the genital area, neck folds, and between the fingers are also common. The disease is long-term, with frequent relapses.

Symptoms of oral candidiasis

• Infection is characterized by the appearance of swelling and a whitish coating on the mucous membranes of the cheeks, lips, and tongue. When the plaque is removed, the surface bleeds, and the patient experiences a burning sensation.
• With oral candidiasis, the tongue and throat become sensitive, and any contact is painful for the patient.
• Signs of oral candidiasis also include cracks in the corners of the lips and redness of the mucous membrane.
• Symptoms of oral thrush include severe dry mouth, a feeling of tightness of the mucous membrane, and roughness of the internal surfaces.
• Patients often complain of increased temperature due to oral candidiasis. Sometimes this disease is accompanied by the appearance of small ulcers on the inside of the lip and cheek mucosa, which are filled with pus and emit a characteristic odor of oral candidiasis.

Signs of oral candidiasis in HIV diseases are slightly different from traditional ones. In this case, the infection spreads quickly and immediately becomes acute, and plaques and plaque appear not only in the mouth, but also in the genital area. With HIV, thrush of the oral mucosa is difficult to treat, so even with minor symptoms it is better to visit a doctor and check your health.

Bacterial stomatitis in children

Necrotizing ulcerative stomatitis is more common in weakened children and is caused by fusobacteria and spirochetes. May be a sign of periodontal disease (progressive destruction of periodontal tissue). It is characterized by the appearance of painful ulcers, weakness, gingivitis (inflammation of the gums), enlarged and painful lymph nodes, difficulty eating, speaking, and bad breath.

Often, erosions in traumatic stomatitis can become infected through dirty hands, toys and other objects, then bacterial stomatitis develops, so it is important to pay attention to antiseptic treatment.

Traumatic stomatitis in children

A specific form of traumatic stomatitis in children is Bednar's aphthae . This is a traumatic erosion of the oral mucosa. In children, unlike adults, the mucosal epithelium consists not of four layers, but of two, so it is easily injured. The cause may be early teething, a rough nipple from the mother, or a long nipple on the bottle. Erosion is most often located in the middle of the palate or opposite the cutting edge of the teeth. The child begins to refuse food, cries, and sleeps poorly.

Traumatic stomatitis also occurs in children when wearing braces. Erosions have uneven edges, are painful, and are usually located on the mucous membrane of the cheeks and lips, less often on the tongue.

Classification of oral candidiasis

This disease is usually divided into several types, each of which has its own characteristic features. Experts distinguish between acute and chronic oral candidiasis.

Acute pseudomembranous candidiasis

Characteristic of infants with weakened immunity. Oral candidiasis, or oral candidiasis, can be triggered by a previous infectious disease or gastrointestinal disorder. The disease is transmitted through a pacifier or dishes; the disease manifests itself in the form of a light or grayish coating on the mucous membrane. At the initial stage, plaque is painlessly removed; with the development of candidiasis of the oral mucosa and pharynx, it thickens and spreads in the oral cavity. It is almost impossible to remove plaque on the tongue without causing bleeding.

Acute atrophic candidal stomatitis

Accompanied by peeling of the integument, dryness and burning of the mucous membrane, it is painful for the patient to eat and touch the infected area. With this form of oral candidiasis, the infection can spread further - to the larynx, pharynx and even the esophagus.

Chronic hyperplastic candidiasis of the oral cavity

It is characterized by a change from a whitish coating to a grayish-yellow one, after removal of which slight bleeding occurs. Along with plaque, plaques and thickenings appear that cannot be cleaned off or removed; they go away on their own during the treatment process.

Chronic atrophic candidiasis of the oral cavity

It is diagnosed when inflammation spreads to the skin and cracks appear in the corners of the mouth. In this case, the tongue becomes a shiny, rich pink color, and the vessels are clearly visible on it. Then the infection spreads to the internal organs. This type of oral candidiasis can occur due to improper installation of dentures, plates and crowns, which rub and injure the mucous membrane.

Drug-induced stomatitis

Occurs when there is an allergy to a drug. Often, allergies can occur to antibacterial, antimicrobial drugs, vaccines, iodine. The mucous membrane is red, swollen, the lips and tongue also often swell, blisters appear, which burst, leaving erosion. The gums are inflamed and bleed when touched. General manifestations are possible, such as urticaria, nausea, vomiting. In severe cases, anaphylactic shock occurs (an emergency condition manifested by decreased blood pressure, shortness of breath, fainting, suffocation), Quincke's edema (an atypical reaction of the body, manifested by rapid and severe swelling)

Both conditions are extremely dangerous and require immediate action and calling an ambulance!

Prevention of stomatitis in children

In children's groups, infections spread especially quickly. Therefore, if a child is infected with the herpes virus, he needs to stay at home until he recovers. Children who have been in contact with sick people should use antiviral ointments for 5 days.

If a pregnant woman has herpes or candidiasis, she should treat it before giving birth. If you have the herpes virus during the period of illness, you should use separate utensils, do not kiss children, and wear a mask.

Kindergartens and other preschool institutions must be cleaned and objects, including toys, must be treated with disinfectants.

To avoid allergic reactions, you should seek help from an allergist to identify existing allergies.

It is worth preventing a decrease in immunity; hardening works especially well in childhood. It is worth limiting your intake of fast carbohydrates, because... they create a favorable environment for the development of candidiasis. An important point is the proper nutrition of the child; regular intake of vitamins, especially vitamin C, is essential.

Tantum® Propolis

For children over 14 years of age , you can use Tantum® Propolis lozenges; they contain a lot of vitamin C, which will strengthen the immune system, and propolis has an anti-inflammatory effect, preventing the occurrence of infections.7
Find out more

Prevention of Bednar's aft is preparing the breasts for feeding, using special creams to soften the skin, prevent cracks, and it is also worth choosing the right bottle. In case of injury due to braces, you need to use orthodontic wax; here it is important to prevent the wounds from becoming infected, so it is better to treat them with antiseptic solutions and sprays.

Tantum® Verde spray will relieve pain at the site of injury and its antiseptic effect will prevent infection.8,9

Thrush in infants

Treatment of thrush in infants depends on the extent of the pathological process. In the early stages, with local damage, local therapy is indicated - irrigation of the oral cavity with anti-candidiasis (clotrimazole, nystatin), alkalizing (2% baking soda solution, 0.25% boric solution) and disinfectants (aniline dyes - Lugol's solution, methylene blue) agents. When breastfeeding, treatment of the mother's breast with a 2% soda solution and herbal infusions (oak, calendula and others) is indicated. Such treatment is carried out until the child recovers completely, but for a period of at least 14 days.

For moderate and severe forms, systemic therapy through oral or parenteral administration of antifungal drugs is recommended. When using anticandidal drugs orally, preference is given to powders for injection (fluconazole), since the prepared solution has not only a general, but also a local effect on the mucous membranes of the oral cavity. In parallel, treatment of concomitant diseases and symptomatic therapy according to indications is carried out in full. According to modern recommendations, this approach should also be used for mild forms, since it allows reducing the treatment time to 3-6 days.

Forecast and prevention of thrush in infants

The prognosis for thrush in infants is favorable. With timely, rational therapy, complete recovery occurs within 7-10 days. Severe forms and the development of complications are observed only in the absence of antifungal treatment. Nonspecific prevention of candidal stomatitis consists of proper care of the child’s skin and mucous membranes, especially against the background of severe pathologies that reduce immunity. An important role is given to the rational use of antibacterial agents and the treatment of fungal diseases in the mother during the period of bearing a child.

Specific prevention of thrush in infants is necessary if there are indications, which include a complicated obstetric and gynecological history of the mother, prematurity and intrauterine malformations of the child, respiratory disorders, birth injuries of newborns, and pathologies of the central nervous system. Newborns included in this group undergo microscopy and bacteriology of samples of mucous membranes and feces during the first 7 days of life. For infants on antibacterial therapy, a prophylactic course of an antifungal drug, usually fluconazole, is prescribed.