Corresponding Author: Dr. Regina Divya, MD Post Graduate in Pediatrics, Mediciti Medical College and Research Institute,

Hyderabad,India. E-Mail: twtbird4@gmail.com Mobile: +91-9573518899

116

Indian J.Pharm.Biol.Res. 2013; 1(4):116-118

Case Report

Atypical presentations of congenital cutaneous candidiasis- presenting

a cohort of 8 cases

Dr. Regina Divya1*

, Dr. Sumathi John2, Dr. (Col.) C.G.Wilson

3, Dr. (Col.) Uma Ramachandran

4

1MD Post Graduate in Pediatrics, Mediciti Medical College and Research Institute, Hyderabad, India.

2Assistant Professor in Pediatrics, Mediciti Medical College and Research Institute, Hyderabad, India.

3Professor of Pediatrics, Mediciti Medical College and Research Institute, Hyderabad, India.

4HOD and Professor of Pediatrics, Mediciti Medical College and Research Institute, Hyderabad, India.

ARTICLE INFO:

Article history:

Received: 8 October 2013

Received in revised form:

22 October 2013

Accepted: 30 October 2013

Available online: 7 December 2013

Keywords:

Vaginal candidiasis,

Pregnant Women,

Antibiotics.

ABSTRACT

Congenital cutaneous candidiasis is an extremely rare disorder that usually presents within

the first 6 days of life. We report 8 neonates who presented with generalized skin eruptions

within first 6 days of life, characterized by erythematous macules, papules, vesicles, bullae

and pustules. Candida albicans was demonstrated on direct KOH smear, fungal culture and

skin biopsy. The disease implies a congenital intrauterine infection and is different from

neonatal candidiasis, which manifests as thrush or diaper dermatitis.Although congenital

cutaneous candidiasis is a rare diagnosis and the predisposing factors like

prematurity,candidial infection in the mother are not obvious, a high index of suspicion is

required to diagnose the neonates with this condition and it is very evident that congenital

cutaneous candidiasis has got a good prognosis. This article apart from revealing the atypical

presentations of cutaneous congenital candidiasis, also emphasizes the need to screen all

pregnant women for vaginal candidiasis .

1. Introduction

Congenital cutaneous candidiasis is an extremely rare disorder

that usually presents within first 6 days of life [1]. We are

reporting a cohort of 8 neonates with cutaneous congenital

candidiasis.

2. Case Report

Out of the 8 neonates, all were term babies and six were born

through elective caesarean section and two were through labor

naturalis. There was history of white discharge per vagina in the

third trimester, in two out of the eight mothers and they were

diagnosed to have candidial vaginitis and treated for the same.

The time of appearance of skin lesions varied from birth to 4

days of life and the nature of the lesions ranged from small

erythematous rashes to bullous / burn like lesions. Urine and

blood culture ruled out bacterial infection in all neonates. KOH

mount and skin biopsy from the lesions revealed candidial

elements and diagnosis of cutaneous congenital candidiasis was

made and were treated with topical antifungals except one

neonate who required systemic antifungals due to systemic

involvement. All the neonates responded well and discharged

home.

CODEN (USA): IJPB07 ISSN: 2320-9267

Indian Journal of Pharmaceutical and Biological Research (IJPBR)

Journal homepage: www.ijpbr.in

Divya et al. / Indian J. Pharm. Biol. Res., 2013; 1(4):116-118

Case Report 117

3. Discussion

Congenital cutaneous candidiasis occurred from a combination

of maternal vaginal candidiasis, prolonged rupture of membranes

and extensive antibiotic usage[2]. Though intra-uterine foreign

body and prematurity are accepted factors predisposing to

congenital cutaneous candidiasis, none of these neonates were

preterm and only one of the mothers had intra- uterine copper-

T[3]. Hence eventhough congenital cutaneous candidiasis is a

rare diagnosis and the predisposing factors are not obvious, a

high index of suspicion is required to diagnose the neonates with

this condition and it is very evident that congenital cutaneous

candidiasis has got a good prognosis. This article apart from

revealing the atypical presentations of cutaneous congenital

candidiasis, also emphasizes the need to screen all pregnant

women for vaginal candidiasis.

FIGURE 1: ONE OF THE NEONATES WITH CONGENITAL CUTANEOUS CANDIDIASIS

FIGURE 2: ANOTHER NEONATE WITH CONGENITAL CUTANEOUS CANDIDIASIS

Conflict of interest statement

We declare that we have no conflict of interest.

Divya et al. / Indian J. Pharm. Biol. Res., 2013; 1(4):116-118

Case Report 118

Acknowledgement The authors are thankful to the management of Department of

Pediatrics, Mediciti Medical College and Research Institute,

Hyderabad, India.

References

1. Congenital Cutaneous Candidiasis: A Rare And

Unpredictable Disease Sujit A Jagtap, Pallavi P Saple,

And Saleha B Dhaliat. Indian J Dermatol. 2011 Jan-

Feb; 56(1): 92–93.

2. White RK, Hussain Z, Desa D. Antenatal Infection

With Candida Species. Arch Dis Child. 1982;57:528–

535.

3. Raval DS, Barton LL, Hansen RC. Congenital

Cutaneous Candidiasis; Case Report And Review. Ped

Dermatol. 1995;12(4):355-358.

All © 2013 are reserved by Indian Journal of Pharmaceutical and Biological Research.

Cite this article as: Dr. Regina Divya, Dr. Sumathi John, Dr. (Col.) C.G.Wilson, Dr. (Col.) Uma Ramachandran. Atypical

presentations of congenital cutaneous candidiasis- presenting a cohort of 8 cases. Indian J. Pharm. Biol. Res.2013; 1(4):116-

118.