Perineal candidiasis, perform dextrostix test!

Key words: Candida, Candidiasis, Napkin dermatitis, Diabetes mellitus, Ketoacidosis

A 16-month-old toddler, admitted for diabetic ketoacidosis, presented with severe perineal candidiasis, which had been persistent for two weeks. Candidiasis is unusual in toddlers, in the absence of risk factors like recent antibiotic course. Glicosuria favours the occurrence of the infection by offering a nutritive source for the pathogen and impairing neutrophil oxidative activity. In toddlers diabetes mellitus is often diagnosed after the occurrence of ketoacidosis, because of the difficulty in recognizing more subtle symptoms like polyuria, polydipsia and hyperphagia. Candidiasis (especially when persistent and scarcely responsive to topical treatment) can therefore act as an early sign of diabetes mellitus, which must be ruled out through a simple urine stix and a dextrostix test.