Candidiasis (Pediatric)

Candidiasis is a fungal infection caused by Candida species, most commonly Candida albicans, affecting the skin, mucous membranes, or systemic sites in infants and children.

Definition

Candidiasis is a fungal infection caused by Candida species, most commonly Candida albicans, affecting the skin, mucous membranes, or systemic sites in infants and children.

Epidemiology

Common in neonates and immunocompromised children
Oral thrush affects up to 25% of healthy infants in the first few months of life
Diaper dermatitis caused by Candida occurs in infants, especially in warm, moist environments
Systemic candidiasis more frequent in premature infants or those in NICU
Increasing incidence in children with broad-spectrum antibiotic use or immunosuppression

Etiology

Candida albicans (most common), Candida parapsilosis, Candida tropicalis
Risk factors: prematurity, antibiotic use, immunodeficiency, indwelling catheters, corticosteroid use
Disruption of normal microbiota promotes overgrowth
Transmission: vertical from mother during birth or horizontal via contaminated surfaces

Pathophysiology

Overgrowth of Candida on mucosal surfaces or skin
Adhesion to epithelial cells and biofilm formation
Evasion of host immune responses leads to persistent infection
Inflammatory response causes erythema, exudates, and discomfort
In systemic infection, hematogenous spread can affect multiple organs
Immune status and barrier integrity determine severity