CONGENITAL CUTANEOUS CANDIDIASIS

By Gary M. White, MD


Congenital candidiasis represents infection of the fetus by Candida which occurred in utero via ascending infection through the maternal vagina through intact membranes. In contrast, neonatal candidiasis results from passage of the fetus through an infected birth canal.

Clinical

A diffuse erythematous maculopapular eruption within the first 12 hours of life that evolves into vesicles and pustules and later desquamation is characteristic. The palms and soles are almost always affected. The mom often has had a bout of vulvovaginitis during pregnancy. Respiratory distress, hepatosplenomegaly and signs of sepsis may occur. The nail plates may be affected.

Diagnosis

It is said that the presence of white microabscesses on the surface of placenta and umbilical cord is pathognomonic. A KOH exam of the skin verifies the diagnosis.

Treatment

Oral and topical antifungal therapy should be initiated. Occasional there may be a need for parental therapy (e.g. fluconazole) if systemic involvement (e.g. Candidal pneumonia) is suspected. If disseminated disease does occur, amphotericin B may be needed.

References

An infant was given topical 2% ketaconazole cream twice daily along with fluconazole 6 mg/kg intravenously once daily for 3 days as there was leucocytosis. Once improvement was obtained, the infant was switched to oral fluconazole (6 mg/kg/week) and topical ketoconazole. Healing was achieved. Congenital Candidiasis. Indian Dermatol Online J 2014;5, Suppl S1:44-7


It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegioinalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegoinalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.