Congenital cutaneous candidiasis

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Congenital cutaneous candidiasis
Other namesBeck-Ibrahim disease [1] [2]
Congenital cutaneous candidiasis.jpg
One-day neonate with rash due to C. albicans, located along the back and extremities.
Specialty Dermatology, infectious diseases, medical mycology
Symptoms Skin, disseminated [3]
Usual onsetBirth - few days [4]
Causes Candida [4]
FrequencyRare [3]

Congenital cutaneous candidiasis is a type of candida infection in newborn babies, which appears as generalized red patches and small bumps on the skin or in the mouth, appearing at birth or a few days after birth. [3] [4] It can also occur as more serious widespread disseminated type. [3]

Contents

It is caused by Candida (a type of yeast), usually as a complication following premature rupture of membranes in a mother with vaginal thrush. [5] : 309  Diagnosis cannot usually be made before birth. [3] It may be suspected by observing white-yellow spots on the placenta and around the umbilical cord. [3] The umbilical cord may have areas of dead tissue or calcification. [3] A sample of the cord under the microscope usually shows inflammation of the blood vessel walls, with lots of white blood cells, and the fungal filaments may be seen when the sample is stained. [3]

It is rare, with 70 cases reported in literature between the years of 1971 and 2011. [3] [6] The earliest known reports of new-born fungal infections in newborns following pregnancy were in the 19th century. [3] The condition was previously known as 'Beck-Ibrahim disease', a term now abandoned due the association of Ibrahim with Nazi euthanasia. [2]

Signs and symptoms

It may present as generalized red patches and small bumps on the skin, appearing at birth or within the first 6 days of life. [3] [4] Lesions may be located on the trunk, extensor surfaces, and folds of the skin [7] . In rare cases, nail dystrophy may occur. [8] There may be inflamed eyes, lung infection, and the baby may have swollen vagina and vulva. [3] It can also occur as a more serious systemic infection, with symptoms of respiratory distress, hepatosplenomegaly, low blood pressure, sepsis, and death. [3] [6]

Diagnosis

Diagnosis cannot usually be made before birth. [3] It may be suspected by observing muddy looking amniotic fluid, or white-yellow spots on the placenta and around the umbilical cord. [3] The umbilical cord may have areas of dead tissue or calcification. [3] A sample of the cord under the microscope usually shows inflammation of the blood vessel walls, a high white blood cell count, and the fungal filaments may be seen when the sample is stained. [3]

Bilirubin may be high and medical imaging may show evidence of pneumonia. [3]

After birth, diagnosis can be made through potassium hydroxide preparation on skin scrapings from the infant. The sample will show yeast and pseudohyphae. Definitive diagnosis requires culturing of the fungus from blood, urine, or cerebrospinal fluid. [7]

Cause

It is caused by Candida (a type of yeast), usually as a complication following in utero premature rupture of membranes in a mother with vaginal thrush. [5] Other potential causes include presence of intrauterine devices or sutures. [7] Candida albicans is the primary pathogen among the Candida genera, and is responsible for roughly 60-75% of neonatal Candida infections. [7] [9] Preterm infants and infants with a low birth weight are at a higher risk for systemic dissemination. [9]

A micrograph of Candida albicans. Candida albicans 1964.jpg
A micrograph of Candida albicans.

Prevention and treatment

Systemic antifungal treatments are used to treat infants at risk for developing systemic dissemination of congenital cutaneous candidiasis. Fluconazole is a common prophylactic antifungal medication to reduce Candida infections in high-risk infants. Other measures such as reduced use of broad-spectrum antibiotics, infection control practices, and strict hand-washing protocols in hospitals lowers the risk of systemic congenital cutaneous candidiasis. [9]

References

  1. ↑ Stedman, Thomas Lathrop (2005). Stedman's Medical Eponyms (2nd ed.). Baltimore, Maryland: Lippincott Williams & Wilkins. pp. 56–57. ISBN   0-7817-5443-7.
  2. 1 2 Strous, Rael D.; Edelman, Morris C. (2007). "Eponyms and the Nazi Era: Time to Remember and Time for Change". Israel Medical Association Journal. 9 (3): 207–214. PMID   17402342.
  3. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Skoczylas, MM; Walat, A; Kordek, A; Loniewska, B; Rudnicki, J; Maleszka, R; Torbé, A (2014). "Congenital candidiasis as a subject of research in medicine and human ecology". Annals of Parasitology. 60 (3): 179–89. PMID   25281815.
  4. 1 2 3 4 Johnstone, Ronald B. (2017). "25. Mycoses and Algal infections". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 445. ISBN   978-0-7020-6830-0.
  5. 1 2 James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN   0-7216-2921-0.
  6. 1 2 Jagtap, SujitA; Saple, PallaviP; Dhaliat, SalehaB (2011). "Congenital cutaneous candidiasis: A rare and unpredictable disease". Indian Journal of Dermatology. 56 (1): 92–93. doi: 10.4103/0019-5154.77564 . ISSN   0019-5154. PMC   3088947 . PMID   21572803.
  7. 1 2 3 4 Tieu, Kathy D.; Satter, Elizabeth K.; Zaleski, Lisa; Koehler, Matthew (2003). "Congenital Cutaneous Candidiasis in Two Full-Term Infants". Pediatric Dermatology. 29 (4): 507–510. doi:10.1111/j.1525-1470.2011.01468.x. ISSN   0736-8046. PMID   21906141 – via Scopus.
  8. ↑ Clegg, Herbert W.; Prose, Neil S.; Greenberg, David N. (2003). "Nail Dystrophy in Congenital Cutaneous Candidiasis". Pediatric Dermatology. 20 (4): 342–344. doi:10.1046/j.1525-1470.2003.20415.x. ISSN   0736-8046. PMID   12869159 – via Scopus.
  9. 1 2 3 Eletel, Lucy; Thomas, Talia; Berry, Emily A.; Kearns, Gregory L. (2025-07-01). "Emerging Treatments in Neonatal Fungal Infections: Progress and Prospects". Pediatric Drugs. 27 (4): 449–463. doi:10.1007/s40272-025-00688-4. ISSN   1179-2019. PMID   40117020.
  10. ↑ "Details - Public Health Image Library(PHIL)". phil.cdc.gov. Retrieved 2025-11-17.
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