Mouth problems

Oral candidiasis

Presentation Differentials Investigations Treatment
White or yellow patches or small plaques
in the mouth (especially on the palate)
Milk after feeding
Aphthous lesions
HSV
Clinical diagnosis Nystatin (100,000U/ml) oral drops tds or
GV-aqueous solution (0.5%)
(continue 3 days after lesions have resolved)

Oesophageal candidiasis

Presentation Differentials Investigations Treatment
Pain on swallowing or crying with
feeding in a patient with oral candidiasis
Clinical diagnosis Fluconazole PO 3-6 mg/kg OD x 2 weeks

Herpes simplex ulcers

Presentation Differentials Investigations Treatment
Painful ulcerations on any skin surface where no other cause is known and not responding to local care and/or antibiotics. May be proceded by painful vesicle.
  • Aphthous ulcers
  • Impetigo
Clinical diagnosis Local antiseptic (GV paint)
For disseminated or severe cases:
Acyclovir 20mg/kg QID (max/dose 800mg) po x 1/52

Avoid acidic drinks and hot food; give sour milk or porridge, soft and mashed food; ice cubes/ice cream or yoghurt may help if available and affordable