The mouth is full of cares. The milkwoman at the baby of
Some parents notice that in a mouth of the baby the whitish raid similar to the milk remains appears. The milkwoman - the disease which is quite often found at small children is so usually shown. What the milkwoman and as she is treated is dangerous by?
What is the milkwoman?
the Milkwoman is one of clinical forms of such disease as candidiasis. This fungal disease of mucous membranes, integuments, nails, internals of the person caused by drozhzhepodobny mushrooms of a sort Candida (Candida). Emergence of the name “milkwoman“ is connected with what during an illness all mucous the struck body becomes covered by a whitish raid which reminds stvorozhenny milk, curdled allocations are formed.
At newborns most often should face oral candidiasis - the milkwoman of mucous membranes of an oral cavity.by
Symptoms of oral candidiasis at children
At an easy form of candidiasis observes the raid in the form of curdled grains which is settling down on limited sites of a mucous membrane of an oral cavity, the sky is more often - on the top surface of language or cheeks. This raid easily is removed. There are no subjective feelings. The smell from a mouth is not felt.
the Medium-weight form of candidiasis is followed by the curdled or filmy raid on the hyperemic (red) basis diffuzno covering cheeks, language, a hard palate, lips. The raid is removed not completely, leaving the bleeding surface of a mucous membrane.the filmy raid entirely covers with
At a severe form of a disease a mucous membrane of an oral cavity, language (glossit), cheeks, gums, a hard and soft palate, a back wall of a throat (pharyngitis), lips (heylit). At a poskablivaniye it is possible to remove only a small amount of a raid, but the whitish film which is strongly soldered to a mucous membrane remains.
At widespread defeat of an oral cavity children become uneasy, badly suck.Kandidozny damage of mucous membranes of an oral cavity can be combined by
with crotch skin candidiasis, pakhovo - femoral and mezhjyagodichny folds, vulvovaginity (an inflammation of genitalia, a mucous membrane of a vagina and vulva - vagina thresholds) and intestinal candidiasis.
of Candida albicans - the most widespread causative agent of candidiasis. The carriage of Candida albicans occurs at healthy people, but is more often - at pathological states. The activator is a part of constant normal microflora of a digestive tract: it can be in an oral cavity, but the greatest colonization is observed in a thick gut. Colonization of a vagina mushrooms of Candida albicans is present at 10 - 30% of healthy women, increasing at pregnancy, active sex life, reception of oral contraceptives. Though Candida albicans can be found on skin about natural openings, she is not the representative of normal microflora of skin but only mucous membranes.
Besides Candida albicans the milkwoman`s reason children can have also other activators - Candida tropicalis, Candida parapsilosis, Candida glabrata, Candida krusei. Special value of an infection, the caused Candida glabrata and Candida krusei, get because activators are steady against one of the main preparations used for treatment of the milkwoman - a flukonazola.
of the Reason of development of oral candidiasis
Candida Mushrooms, being almost constant flora of the person, at creating favorable conditions can become pathogenic, i.e. in similar cases intensive reproduction, violation kozhno - mucous barriers and destruction of the subject fabrics begins that is followed by an inflammation.Ability to cause a disease, reproduction in an oral cavity are connected by
with decrease of resilience of a macroorganism (the child`s organism) which is possible under the influence of various factors which are negatively influencing an organism. At the same time microbic balance is broken, sharp candidiasis develops.
In development of candidiasis the significant role is played also endogenous (internal, from the child), and exogenous (external) factors.
treat endogenous factors:
- of Anomaly of development of children, prematurity of a fruit and the underdevelopment of physiological functions connected with it which favor to development of a disease. The milkwoman meets at the children who are on artificial feeding from more often - for shortages of factors of protection which the child receives with breast milk.
- of the State after surgeries, a gipovitaminoza (the state developing owing to insufficient intake of vitamins B an organism), hypotrophies (the chronic disorder of food which is characterized by various extent of loss of body weight at children of early age), anemias (the states which are characterized by decrease in content of hemoglobin in blood are more often at simultaneous reduction of quantity of erythrocytes), rickets (gipovitaminoz with insufficiency of vitamin D at children of early age, characterized by frustration of a calcic and phosphoric exchange; it is shown by violations of a kosteobrazovaniye, functions of nervous system and internals), dysbacteriosis (the state which is characterized by quantitative and high-quality violations of structure of normal microflora with change of the environment of its dwelling), chronic and sharp infections, metabolic disorders (carbohydrate, proteinaceous, fatty), endocrine violations (diabetes, etc.) and other system diseases which lead to weakening of protective functions of an organism and can promote development of candidiasis.
- Vomiting, vomiting.
treat exogenous factors:
- Mechanical and chemical trauma. Mucous a mouth at the baby very gentle, krovosnabzhatsya plentifully and is easily vulnerable. At a microtrauma and a mechanical trauma integrity of a blanket of skin - epidermis is broken and “entrance gate“ for hit in an organism of mushrooms from the outside or own, living on skin and mucous membranes are created. Immaturity of a mucous membrane of an oral cavity, dryness mucous (newborns have a mucous membrane rather dry), processes of fermentation at sour reaction of saliva, change at inflammatory processes are of also great importance. All this promotes easy fixing of mushrooms on a surface of a mucous oral cavity. under the influence of antibiotics activity of a number of microorganisms in other bodies is suppressed with
- , in particular, the normal intestinal flora which the enzymes participates in synthesis of vitamins is broken. The shortcoming them has an adverse effect on organism resilience. The normal intestinal flora promotes maintenance of necessary pH of the environment which also prevents development of pathogenic flora. Application of medical hormonal preparations and immunodepressants, tsitostatik sharply reduces protective forces of an organism of the child that also promotes development of severe forms of candidiasis.
- the Early beginning of artificial feeding, especially mixes with the increased content of sugar. Children are deprived of an opportunity to receive protective antibodies together with mother`s milk, and the increased content of sugar changes acidity of the environment in a mouth and promotes reproduction of mushrooms.
- Pathogenicity and virulence of a strain of drozhzhepodobny mushrooms. Aggressive properties of mushrooms of the sort Candida increase with oppression of protective properties of a macroorganism, and also in the presence of association with other species of mushrooms, viruses, bacteria. Dangerously intrahospital infection with sort Candida mushrooms. They in a large number circulate in hospitals, are capable is long to remain in environment. These strains of mushrooms are characterized by many antimycotics resistance and disinfectants.
- Presence of a kandidozny vulvovaginit (fungal damage of a vagina, a vulva) at mother during pregnancy. It promotes pre-natal and intranatalny (at the time of delivery, when passing the child on patrimonial ways) to infection of a fruit, and also development of a kandidozny infection in the postnatal period, for example through breast milk and nipples. At pregnant women the disease usually has recidivous character and badly gives in to therapy.
- Infection can also happen at contact with medical personnel, the relatives and other people who are carrying out care of the child who are carriers or are sick with any form of candidiasis. A high probability of infection in the presence of superficial forms of candidiasis of skin and nails. Mushrooms are transmitted through hands, intubatsionny tubes, the devices AVL (artificial ventilation of lungs), diapers, nipples, toys etc.
If the child had the milkwoman`s symptoms...
At the first suspicions on the milkwoman at the child should address the pediatrician as at development of the milkwoman it is necessary to establish the process reason precisely. It can be the first display of any disease which other signs only the expert at survey can reveal and additional inspection of the child. The doctor taking into account specific features of an organism of your child, the allergic mood accompanying pathology, reception of other medicines also has to determine treatment volume. Often it is not enough treatment of the milkwoman only by means of local processing of the centers of defeat as there can be other form of candidiasis, most often - intestinal or vaginal candidiasis. Intestinal candidiasis most often diagnose at detection of mushrooms of the sort Candida in a koprogramma (cumulative researches and the description of a physical, chemical and microscopic state a calla) and in results of inspection a calla on dysbacteriosis. About damage of a vagina at children judge by existence of manifestations on genitalia (existence of hyperaemia - reddening, puffiness and dryness of a mucous membrane of small vulvar lips, a clitoris, a virgin pleva, stratification of dry curdled films, dot and more extensive erosion - superficial defects of skin or mucous membrane) and by positive results of microscopic and bacteriological research on drozhzhepodobny mushrooms of Candida. Reception of system preparations which dose and term of reception only the expert can define is necessary for high efficiency of treatment.
Should examine mother on existence of candidiasis. If mother has a milkwoman, so she can appear also at the kid.
Diagnostics of the milkwoman
Oral candidiasis is diagnosed by
on the basis of clinical data, and additional mycologic research can usually be not conducted. The positive effect of local specific therapy validates the diagnosis.
Full diagnostics of kandidozny defeats is based on data of a clinical picture, microscopic and cultural researches, serologichesky reactions.
At microscopic research are done by soskoba from mucous membranes and material is considered under a microscope. This method allows to reveal drozhzhepodobny cages and threads of a mycelium of mushrooms of Candida.do to
At bacteriological research crops, the number of colonies of mushrooms of Candida, a species of a mushroom of Candida and its susceptibility to antifungal preparations is defined. For this purpose influence the colonies of a mushroom which grew on a nutrient medium various antifungal preparations and watch what preparation is more effective.
tolerance of a species of a mushroom to treatment by certain preparations can Sometimes be the cause of inefficient treatment of candidiasis. In this case surely conduct similar research.
At serologichesky research (research at which in serum of blood of the person antibodies are investigated) of the most reliable is the reaction of binding of a complement (RBC) with barmy anti-genes. Research reveals antibodies to Candida mushrooms. At the majority of sick RSK happens positive even to a small amount of antibodies.
Treatment of the milkwoman
In treatment paramount is identification and elimination of all factors which led to development of a disease. At initial, superficial, local forms of the milkwoman it is necessary to carry out only local, external therapy by an irrigation of the centers by freshly cooked protivokandidozny, disinfecting, alkalizing preparations.
Affected areas are cleared by the sterile wadded ball moistened in water solution margantsovo - sour potassium (it is pale - pink solution), 0,25% water solution drills, 2% water solution of soda (on 1 glass of boiled water of room temperature - 1 teaspoon of baking soda), 1 - 2% water solution of tannin, 0,25 - 1% solution of peroxide of hydrogen. After each such processing of a mouth it is necessary to grease affected areas (but no more than 5 days in a row) 1 - 2% water solution of aniline dyes: gentsianvioleta, methylene blue; 0,25% solution azotno - sour silver; yodinoly, divorced boiled water 1:2, the lugol solution divorced boiled water 1:3. It is necessary to repeat this procedure every 2 - 3 hour.
Can process mucous oral cavities water suspension of nystatin or a levorin, they can be prepared independently: to pound a tablet and to mix with water. levorin prepare at the rate of 100 thousand pieces on 5 ml of the boiled or distilled water. Nystatin suspension at the rate of 250 thousand pieces on 5 ml of the boiled or distilled water, alternates with 5% solution of a hydrocarbonate of sodium. Processing is carried out by each 6 hours.Suspension of a 2,5% pimafutsin for local application the mucous membrane is processed by
4 - 6 times a day depending on extensiveness of defeat. Also 1% solution of a klotra is used - smeared (kanesten, Candide) for external application 2 - 3 times a day.All manipulations at children of any age have to be made by
gently and softly, without pressing. It is necessary to watch that the child could not inhale or swallow vatu. It is not necessary to start processing right after feeding not to provoke vomiting.
If mother nurses the child, then during treatment it is desirable to wash after each feeding a breast water, then to process nipples 2% soda solution (on 1 glass of boiled water of room temperature 1 teaspoon of baking soda) or herb infusion (an eucalyptus, a calendula, an oak, a camomile). Before feeding it is also necessary to wash and process nipples soda solution. In the period of the milkwoman it is necessary to boil any subject which can appear in a mouth at your child.Treatment is carried out by
before absolute clinical recovery, but not less than 14 days as disappearance of symptoms does not guarantee elimination of the activator. On need of extension of term of treatment the decision is made by the attending physician. >
But at the present stage it is considered p by the most effective and convenient method of treatment of any form of candidiasis at children of any age applied inside (through a mouth) flukonazol (Diflucan, diflazon, etc.) 6 mg/kg once and further on 3 mg/kg of 1 times a day. For this purpose it is possible to use powder for injections. Powder can be mixed with a small amount of milk or boiled water. It is better to give medicine from a teaspoon, at the same time greasing affected areas of a mucous membrane of an oral cavity. At application of a flukonazol terms of treatment are reduced to 3 - 5 days.to
At a severe form of candidiasis, lack of efficiency from the carried-out therapy needs treatment in the conditions of a hospital, with possible intravenous administration of antimikotichesky preparations.