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matitis
Stomatitis
S to m a titis is a n in fla m m a tio n o f th e m uco us m em b ra n es o f th e m o uth
ca us ed b y a
fun ga l, vira l o r b a cteria l in fectio n , a vita m in d eficien cy, a n in jury, etc.
Pro lo n ged o r pa in ful s to m a titis m a y co n trib ute to d ehyd ra tio n o r m a y ca us e lo s s
of
a ppetite w ith d en utritio n , pa rticula rly in child ren .
In in fa n ts , exa m in e ro utin ely the m o uth in the even t o f b rea s t refus a l o r d ifficulties in
–s uMckina ign. t a in a d eq ua t e h yd ra t io n a n d feed in g; o ffer fo o d s t h a t w ill n o t irrit a t e t h e
In a ll ca s es :
– mKeuecpothseam(soouftth, ncleoann-atocidpirce)v. eUn st ceoamnpalicsaotigoansstriac ntudb erefcourraenfecwe. d a ys if pa in is
preven tin g
the pa tien t fro m ea tin g.
Oral and oropharyngeal candidiasis
In fectio n d ue to Candida albicans, co m m o n in in fa n ts , im m un o co m pro m is ed o r
d ia b etic
pa tien ts . O ther ris k fa cto rs in clud e trea tm en t w ith o ra l a n tib io tics o r high-d o s e
in ha led
co rtico s tero id s .
Clinical features
W hite pa tches o n the to n gue, in s id e the cheeks , tha t m a y s prea d to the pha ryn x.
I n pa t ien t s w it h freq uen t recurren ces o r ext en s ive fo rm s in va d in g t h e es o ph a gus
(s w a llo w in g d ifficulty a n d pa in ), co n s id er H IV in fectio n .
Treatment
nystatin (to b e ta ken b etw een m ea ls ): 4 0 0 0 0 0 IU / d a y, i.e. 1 lo zen ge to b e s ucked
or1 m l
o f the o ra l s us pen s io n (1 0 0 0 0 0 I U ) 4 tim es / d a y fo r 7 d a ys . T he o ra l
s us pen s io n s ho uld
b e s w illed a ro un d the o ra l ca vity a n d s w a llo w ed , o r, in yo un g child ren , a pplied to the
to n gue a n d the in s id e o f ea ch cheek.
S ho w the m o ther ho w to trea t s in ce in m o s t ca s es , ca n d id ia s is w ill b e trea ted a t
ho m e.
In im m un o co m pro m is ed pa tien ts : s ee pa ge 2 1 4 .
Oral herpes
In fectio n d ue to the herpes simplex virus . Prim a ry in fectio n typica lly o ccurs in child ren
a ged 6 m o n ths -5 yea rs a n d m a y ca us e a cute gin givo s to m a titis , s o m etim es
s evere. A fter
Stomatitis
S to m a titis is a n in fla m m a tio n o f th e m uco us m em b ra n es o f th e m o uth
ca us ed b y a
fun ga l, vira l o r b a cteria l in fectio n , a vita m in d eficien cy, a n in jury, etc.
Pro lo n ged o r pa in ful s to m a titis m a y co n trib ute to d ehyd ra tio n o r m a y ca us e lo s s
of
a ppetite w ith d en utritio n , pa rticula rly in child ren .
In in fa n ts , exa m in e ro utin ely the m o uth in the even t o f b rea s t refus a l o r d ifficulties in
–s uMckina ign. t a in a d eq ua t e h yd ra t io n a n d feed in g; o ffer fo o d s t h a t w ill n o t irrit a t e t h e
In a ll ca s es :
– mKeuecpothseam(soouftth, ncleoann-atocidpirce)v. eUn st ceoamnpalicsaotigoansstriac ntudb erefcourraenfecwe. d a ys if pa in is
preven tin g
the pa tien t fro m ea tin g.
Oral and oropharyngeal candidiasis
In fectio n d ue to Candida albicans, co m m o n in in fa n ts , im m un o co m pro m is ed o r
d ia b etic
pa tien ts . O ther ris k fa cto rs in clud e trea tm en t w ith o ra l a n tib io tics o r high-d o s e
in ha led
co rtico s tero id s .
Clinical features
W hite pa tches o n the to n gue, in s id e the cheeks , tha t m a y s prea d to the pha ryn x.
I n pa t ien t s w it h freq uen t recurren ces o r ext en s ive fo rm s in va d in g t h e es o ph a gus
(s w a llo w in g d ifficulty a n d pa in ), co n s id er H IV in fectio n .
Treatment
nystatin (to b e ta ken b etw een m ea ls ): 4 0 0 0 0 0 IU / d a y, i.e. 1 lo zen ge to b e s ucked
or1 m l
o f the o ra l s us pen s io n (1 0 0 0 0 0 I U ) 4 tim es / d a y fo r 7 d a ys . T he o ra l
s us pen s io n s ho uld
b e s w illed a ro un d the o ra l ca vity a n d s w a llo w ed , o r, in yo un g child ren , a pplied to the
to n gue a n d the in s id e o f ea ch cheek.
S ho w the m o ther ho w to trea t s in ce in m o s t ca s es , ca n d id ia s is w ill b e trea ted a t
ho m e.
In im m un o co m pro m is ed pa tien ts : s ee pa ge 2 1 4 .
Oral herpes
In fectio n d ue to the herpes simplex virus . Prim a ry in fectio n typica lly o ccurs in child ren
a ged 6 m o n ths -5 yea rs a n d m a y ca us e a cute gin givo s to m a titis , s o m etim es
s evere. A fter
