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Abstract: Neonatal infections are common in newborns, including oral infections and pulmonary infections, and thrush is a common oral infection in newborns. The case in this article is a 10-day-old baby who came to the clinic with white spots on the oral mucosa with reduced milk production, and was diagnosed with thrush after examination. After 1 week of treatment with 2% sodium bicarbonate solution + mycophenolate tablets + Clostridium typhimurium tablets, the oral white spots disappeared, milk production resumed, and weight gain was observed.
【Basic information】Female, 10 days
Type of disease】Cushings
Hospital】Fudan University Hospital of Pediatrics
Date of Consultation】September 2021
Treatment plan】Medication (2% sodium bicarbonate solution, mycophenolate tablets, Clostridium typhimurium tablets)
[Treatment period] 1 week of home treatment followed by outpatient visit
Effectiveness】Disappearance of oral white spots, recovery of milk production, weight gain
I. Initial consultation
The parents brought their 10-day-old baby to the clinic. The baby was delivered at full term, fed with milk powder after birth, with normal spirit and appetite, and a few white spots were found on the oral mucosa 1 week after birth, like milk flakes, initially located on the right side of the buccal mucosa, because the child’s spirit and appetite were normal, the family did not pay attention to it, but 3 days later the white spots increased significantly and were found on the tongue and lips, which could not be wiped off, and the amount of milk decreased, so the child came to the clinic. The child’s mental complexion was good, and there were white spots on the buccal mucosa and palate bilaterally, and a little on the lower lip. The routine blood test was normal, and the diagnosis of thrush was made based on clinical experience combined with the test results, and local medication was recommended for outpatient follow-up.
II. Treatment history
Since the child’s general condition was good, with no fever, depression, abnormal crying, etc., but the milk quantity was somewhat affected, we recommended outpatient medication and regular follow-up. The child was given 2% sodium bicarbonate solution for mouth rinsing, crushed mycophenolate tablets for topical application, and Clostridium typhimurium tablets for oral administration, and careful feeding was observed to see whether the white spots in the child’s mouth faded and whether milk consumption resumed. Parents were instructed to bring their children to the outpatient clinic for follow-up after 1 week to assess the treatment effect.
III. Treatment effect
After 1 week of medication and careful care, the child was found to have completely disappeared from the white spots in the oral cavity at the time of follow-up visit. Since the child’s condition has recovered well, there is no need for further review if there are no other abnormalities. Parents should pay more attention to his milk consumption, skin and mucous membrane color, bowel movement and mental status.
Precautions
After treatment, the child’s condition has recovered and his weight has increased, which is a great relief to the attending doctor. However, it is recommended that after the child goes home, the family should also follow the medical advice to take care of the oral area and maintain oral hygiene. The air should be kept circulating in the room during the stay at home to reduce the chance of infection. When feeding the baby, avoid rushing and pay attention to the way of feeding to avoid choking and coughing. Also make sure your baby has enough sleep. If a family member develops an infectious disease, such as influenza or a fungal infection of the skin mucosa, reduce close contact with the baby to avoid causing it to become infected.
V. Personal insight
Thrush, also known as snow mouth disease, is a Candida albicans infection that occurs in immunocompromised newborns. Most newborns with thrush are related to contamination of the birth canal or contamination of milk utensils, and mucosal areas such as the cheek of the mouth, back of the tongue, and palate are good sites for thrush, which can fuse into flakes in severe cases. If such symptoms appear, it is important to seek prompt medical attention. Through early clinical intervention and treatment, good results can be achieved, as in the case of the child in this article, not only are the symptoms relieved, but the milk volume returns to normal and the weight increases normally.