Infants may have trouble feeding in severe cases. Medical history Recent antibiotic or steroid use may suggest a predisposing cause. Diarrhea, rashes, failure to thrive, hepatosplenomegaly, or repeated infections suggest an underlying immunodeficiency. Maternal history Vaginal candidiasis is a source of perinatal exposure to infection. HIV status may provide a clue to a predisposing factor.
Lesions often start as tiny focal areas that enlarge to white patches.
When scraped with a tongue blade, lesions are difficult to remove and leave behind an inflamed base that may be painful and may bleed. Candidal infection in the diaper area may accompany thrush. Examine an infant with diaper dermatitis for oral lesions. Thorough physical examination is critical, especially for patients with recurrent thrush infections and for older children. Systemic antibiotic use may disrupt the normal flora, promoting candidal overgrowth.