Update: October 2018 An oral thrush is contagious
a disease caused by yeast-like fungi of the genus Candida. It
can develop at any age, and in children, starting with
preschool age is a kind of decline marker
immunity or the development of diabetes.
At the age of one year, it occurs most often due to
forced admission of antibiotics by the child or his nursing mother,
and in newborns – during the passage in labor through the colonized
Candida birth canal.
And even though the disease is recorded in every fifth baby, in
this age is better treatable. The main thing – on time
pay attention to it and perform only those actions that
recommended in your case district pediatrician.
About the pathogen
Thrush-causing candidiasis is a whole group of different
fungi: Candida albicans, Candida krusei, Candida tropicalis and
pseudotropicalis, Candida guilliermondi. They live in the surrounding
environment, as well as in the mouth, in the vagina and colon of a person, peacefully
coexisting with other microorganisms and, while the immunity is strong, not
causing signs of illness. Once in the body are created
special conditions (reduced overall immunity or increased pH
mucous membrane), Candida begin to actively proliferate –
thrush develops. The same situation can develop if
a rather large amount of man enters from the environment
mushrooms more “aggressive” subspecies.
�”Favorite” conditions for the development of the fungus Candida – acidic and
temperature 30-37 degrees. Then they are embedded in human tissue.
deeper, releasing enzymes that dissolve tissue components (in
mostly squirrels), and begin to multiply. To mucosal tissues
numerous nerve membranes of the mouth and throat cavity
endings, and when cells are damaged, the nerves signal
brain, and he gives the command to notify the person himself so that
some measures were taken. So there are symptoms of thrush:
pain, burning in the mouth, which is why the child refuses to eat
When favorable conditions are created for the Candida microbe,
actively multiplies, forming long chains of cells with weak
the connection between them is pseudo-mycelium. This structure as well
destroyed mucous cells, food debris and a substance called
fibrin and keratin – and that is the white plaque that is found
on mucous membranes with thrush.
Having multiplied in sufficient quantity, microbes acquire
the ability to spread along healthy tissues — skin and
mucous membranes. So, the complication of untreated thrush cavity
the mouth can become a lesion of the pharynx, esophagus and other internal
organs. The fungus can also enter the bloodstream, causing blood infection.
Candida is perfectly transmitted from person to person with direct
contact of infected skin or mucous membranes with non-infected tissue. BUT
if at some point the microbe gets unfavorable for
own life and breeding, it is covered by a double protective
shell and hibernates, which can last indefinitely
Causes of disease
Thrush in a child’s mouth occurs when the fungus
on its mucous membranes:
|At the newborn (from 1 to 28 days of life)||Monthly baby||In children up to a year||In children older than one year|
The chance of getting infected in premature babies, children,
Especially high chance of occurrence in premature babies, those whose
Основные the reasons – такие же, как и у детей до года.
Also Children under one year old fall ill when:
|The reasons are the same as in children under one year. Also added:
Thrush in the mouth of such children can be the first sign:
Dysbacteriosis due to malnutrition, reception
Thrush in an infant appears very often – up to a year.
5-20% of children suffer this disease, some – repeatedly.
This is due to the fact that the immunity of the mucous membranes of the mouth in such
babies not yet formed, the microflora living there is prone to
frequent changes. And the epithelium itself, from which it is made
surface of the oral cavity, not yet fully formed. therefore
thrush arising up to a year is not a reason for panic.
Urgent need to be examined occurs if parents
they saw thrush in the mouth of a child over a year old, when
The next month did not take antibiotics.
How to see thrush in time
By the first symptoms of thrush in children’s mouth, recognize extremely
hard: it is the redness and swelling that may appear on
palate, tonsils, gums, tongue and inside of the cheeks. Next on
the red shiny background of the mucous membrane that is already starting
ache and itch, white grains appear, similar to
semolina. They can be easily removed with a spoon.
The next step is to increase the plaque, which is already becoming
similar to the remains of cottage cheese in the mouth (less often – it has a grayish or
yellowish tint). If you remove them with a blunt object (spoon,
with a spatula), under them will be visible a red shiny surface, on
which, if you scrape hard, drops of blood appear,
resembling dew. A change in the mucous membrane is accompanied
pain and burning in the mouth. They are aggravated by swallowing food and
eating food, especially if it is spicy, hot or sour.
Present in the mouth and metallic taste. Because of this baby
cries and refuses to eat. In the absence of treatment and on this
stage, or if the child’s immunity is severely depressed, white films
extend further, body temperature rises,
sleep is disturbed, the infant can often regurgitate and stop
The feeling of “coma in the throat”, which
only older children can complain – this is a sign that
thrush has spread to the throat.
Sometimes thrush in children looks like a jam – a crack in the corner
mouth It differs from Jade formed with vitamin A deficiency.
the fact that around the crack there is redness, and she is covered
whitish bloom. Candida zadea rarely accompanied by an increase
temperature or deterioration of the general condition, but it does
opening the mouth is painful. This form of thrush is more common in
children who suck on a pacifier or finger.
Therefore, parents of infants should be alert and
examine the baby’s mouth if he:
- crying when he takes a nipple or breast in his mouth;
- refuses breast;
- capricious, he has a high temperature without snot and
The severity of oral thrush
Consider how mouth candidiasis can occur in children so that
right from the start parents could figure out how to have
to treat the disease – in the hospital or at home.
First, red cavities appear on the mucosa of the oral cavity company.
specks that soon become covered with white plaques,
similar to cottage cheese and not having a tendency to merge. If a
clean plaques, under them will be just redness.
On the mucous membranes appear separate cheesy plaques on red
and puffy background, they merge and gradually capture the entire
mucous membrane If a снять такой налет, под ним обнаруживается
bleeding surface accompanied by touching
pain and cry baby. The language is going to a large layer of white
The baby feels pain when he chews (sucks the breast) and swallows, therefore
he begins to refuse to eat or to be anxious before
After reddening large areas of the mucous shell on what
the child reacts with anxiety and crying, they appear
cheesy raids. These raids appear in both language and
the mucous membrane of the cheeks, and gums, and even go to the lips and
the throat – the look of one big white film is created.
The general condition of the child suffers: its temperature rises,
he refuses to eat, and becomes lethargic. If a не предпринять мер,
dehydration occurs and the microbe can penetrate deep into
How to make a diagnosis
Of course, you can suspect thrush when you compare
manifestations visible in the mouth of your own child, with pictures, where
manifestations of this disease are shown. But a pediatrician or ENT doctor,
make an accurate diagnosis. True, and it requires confirmation in the form
посева налета, взятого изо mouth The fact is that Candide is several, and
not each of them lends itself to standard therapy. Then in case
if the initial treatment does not help, based on
Bakposeva and determine the sensitivity of the fungus to antifungal
drugs, the doctor will be able to prescribe a reasonable treatment, which
Suitable for a child of this age.
For the diagnosis of thrush is not suitable any environment for which
bacteriological seeding is performed to search for bacteria. therefore
in the direction of the analysis, the doctor indicates or presumptive
diagnosis (“Candidiasis”), or indicates the medium to be planted
material (for example, Candichrom II).
The delivery of bakposeva is made on an empty stomach, before the child
drink water or brush your teeth.
In the diagnosis may need such a method of research
as an indirect laryngoscopy, which holds the ENT doctor. She need
in order to understand how deeply it spreads
defeat – captures the throat and larynx, or not. It requires
special efforts of the parents, the doctor and his assistant.
Also important for diagnosis:
- complete blood count: it will show the level of inflammation and
the involvement of the organism in this process, according to this analysis
- blood glucose (as thrush is a marker of sugar
- immunogram – during the illness, as well as a month after it,
to assess the activity of immunity.
To say how to treat thrush in a child’s mouth, should or
ENT doctor, or pediatrician: the disease is serious, and at the same time there is
drug restrictions in childhood.
So, treatment of thrush in children’s mouth begins with
- stop the flow of fungus into the oral cavity: all boil
jars, nipples, handle toys, nursing moms will need
wash your breasts with laundry soap and handle your nipples between
feeding solution “Miramistin” (“Miramidez”);
- excluded from the diet of a nursing mother or the child itself (if
ill child older than a year) sweet foods.
Diet for a nursing mother or child older than a year:
|Can||It is impossible|
- Antibiotics, although they cause the development of thrush, cancel
you can’t do it yourself: so you can achieve serious complications with
the side of those infections, the destruction of which was directed
Treatment of the oral cavity is the basis of treatment for children under 6.
months, and a mandatory component of treatment for older children.
For children up to 6 months, the treatment consists in treating the cavity.
- 1% solution of soda, which is prepared from 1 tsp of food
soda, which is added to 1 liter of warm boiled water and thoroughly
- solution “Candide”, which should be applied to a cotton ball, and
remove raids 3-4 times a day. This drug should be
appointed only by a doctor.
If a у ребенка повышена температура, или творожистый налет
spreads quickly, take your 1% soda solution, and
contact for hospitalization in the hospital: there will be a child
help needed to maintain his condition.
For children older than 6 months, but only if prescribed by a pediatrician,
You can use the drug “Futsis DT”. It must be taken in a dose of 3
mg / kg (that is, if the child weighs 8 kg, then only half a pill),
dissolve it in 4-5 ml of boiled water, and process the cavity
mouth, without fear that the child will swallow it. For this purpose you can
take the Candide solution, and, without diluting it, process the plots
inflammation. From 6 months you can also apply the solution
Children older than 6 months in case of moderate and severe
the course of the disease can be prescribed already and systemic treatment –
�Fluconazole (Mikosist, Diflucan) at a dose of 3 mg / kg per day
once. To do this, take a tablet or capsule of the drug,
containing 50 mg, dissolved in 5 ml of boiled water and given
as many ml as needed (for example, for a child 10 kg of weight is 30
mg, i.e. 3 ml).
For children over 1 year old except Fluconazole at a dosage of 3 mg / kg
weights per day, and soda rinses are also appointed:
- local treatment of lesions with nystatin ointment (especially in
case of candidal bunks), “Miramistin”, Lugol’s dissolution (if
no allergy to iodine);
- can be used (provided that the child not swallow)
the rinse prepared in this way: the tablet “Nystatin”
crush, dissolve (to the maximum) in 10 ml of physiological
sodium chloride solution and 1 ampoule of vitamin B12;
- B vitamins;
- iron preparations (“Ferrum-Lek” syrup);
- calcium gluconate;
- with itching – antihistamines (“Fenistil”, “Erius”).
Please note: Vfend (Voriconazole) is not
applies up to 5 years, “Nystatin” – up to 12 years. Process cavity
using Hexoral or Maksicold ENT sprays is possible only with
3 years old when a child learns to hold his breath in front of a local
using the drug.
If the child refuses due to damage to the oral mucosa
eating and drinking, going to the hospital is a must. Fasting and
lack of fluid intake of the body to be non
How to treat the oral cavity in children under 3 years
To carry out the treatment needed:
- 2 sterile marlechki in such size that it was possible them
wrap on a finger;
- a glass of boiled water, cooled to room temperature;
- antiseptic solution (usually “Miramistin”) or soda.
At first, the parent washes his hands. Then he prints gauze,
reels it on his index finger, dunks it into a glass with
water and gently frees the mouth from raids. Next you need to throw
this gauze, take a new one, and repeat the same soda manipulation
solution or antiseptic.
Perform such a manipulation should be 5-6 p / day, after feeding
and for the night.
It is in compliance with the following activities:
- boiling nipples and bottles;
- washing the breasts before feeding;
- processing toys;
- treatment of thrush during pregnancy;
- timely use of lactic acid bacteria in the treatment
antibiotics and hormonal drugs;
- restriction of access to the child to people with diseases
mouth, hands and nails;
- early brushing your teeth with boiled water and special
- timely, but not early introduction of complementary foods, optimally from
fresh vegetables, fruits and dairy products.
BUTвтор: Кривега Мария Салаватовна врач-реаниматолог