Congenital Candidiasis

There are two types of yeast infections a baby can get when born, one is called Neonatal Candidal infections, and will be explored in another article. This covers the types of yeast infections a baby may get a few weeks after being born. The other type which is what this article is about is Congenital Candidiasis. Congenital Candidiasis can be more serious than Neonatal and can even be fatal for the baby. The following information is to help expectant mothers or new mothers to understand the condition, not to scare you. Any questions you have should be written down so that you can ask your doctor. Do not be afraid or hesitate to ask them anything at all.

There are two types of Congenital Candidiasis, Congenital cutaneous candidiasis and Congenital systemic candidiasis.

Congenital cutaneous candidiasis
A baby with Congenital Candidiasis often has a rash that first starts on the chest and face within in the first 12 hours after birth but then spreads over the next few days after he or she has been delivered. The rash can become maculopapular a few hours after birth, or it can be present at birth. Maculopapular means the rash is red with bumps on it (macules are spots on the skin that are small, flat and discoloured, and papules are bumps that are small and raised).

After one to three days these bumps as they get worse become vesicular, then either bullous or pustular. The whole of the surface of the skin can be affected even the soles of the feet and the palms of the hands. Usually the mouth and diaper area are spared though, at least at first. If it stays as just a skin condition it can be cleared up with treatment within 7 days. The overall health of the baby apart from the rash is fine. It is just if it becomes internal that comes with it a high mortality rate.

Congenital systemic candidiasis
A Congenital Candidiasis infection can not just affect the skin of the baby but can also adversely affect the internal organs, and the gastrointestinal tract which makes it a very serious condition that can be fatal, particularly for babies born at very low weights. At least 50% of babies with congenital systemic candidiasis do not develop the rash described above. Often a baby with congenital systemic candidiasis will also have pneumonia and or a respiratory disease caused by the internal infection in their lungs.

Causes
Congenital Candidiasis is very rare, less than 100 cases were reported in the U.S during the 1990s. Whether the baby gets it has nothing to do with if it is vaginal delivery, if the membranes ruptured prematurely , if the baby is premature, how old the mother is or how long the labor was. It is the manifestation of an intrauterine infection. Intrauterine refers to a method of birth control where an object is inserted into the woman’s uterus to stop any sperm fertilizing an egg. If a pregnancy still occurs while that birth control is still there an infection can occur.

Studies
In babies over 1kg the rash was observed with pustules, vesicules and bullae evolving. In babies under 1kg if the rash presented it was more than 60% of their bodies and this group were more likely to present with a systemic infection. 67% presented with the systemic infection and 40% died. In babies over 1kg this was lower with 10% getting the systemic infection and 8% dieing.

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