150 An Introduction to Medical Mycology 



times ill babies only a few days old. A whitish, loosely adherent membrane is 

 attached to the inner surface of the cheeks or to the palate and sometimes 

 to other portions of the oral mucosa. 



g. Superficial glossitis. This is manifested by a beefy-red, smooth, some- 

 times mottled or enlarged, tongue. Stomatitis is often associated. 



h. Water bed dermatitis. Kumer and others noted that many patients 

 acquired an eruption when kept in continuous baths, when wet applications 

 of bland nature were applied over long periods or occasionally when occlu- 

 sive dressings were left on a part for a considerable time. The affected skin is 

 macerated and peels off, a red base may be noted, and satellite vesicopus- 

 tules may be present. It is to be noted that other yeastlike micro-organisms 

 may be present, and, as with M. albicans, they may be living a solely sapro- 

 phytic existence. 



i. Eczema. White and others have noted the occurrence of yeastlike 

 organisms in cases of typical infantile eczema. There is some doubt as to 

 whether M. albicans is able to cause this type of response. Many instances 

 of secondary cutaneous thrush (in children) or of moniliids may be mis- 

 takenly considered to be eczema. 



j. Vaginitis. The finding of M. albicans in the vagina does not neces- 

 sarily denote more than an asymptomatic involvement. There is little 

 doubt, however, that the organism may produce vaginitis with a low grade 

 inflammatory response accompanied by a thin discharge. Pregnancy and 

 diabetes are considered to be important conditioning states. Pruritus may 

 be a troublesome symptom. Rubbing and scratching often lead to sec- 

 ondary pyogenic infection and eczematization, either or both of which 

 may become sufficiently severe to mask the original infection. It is believed 

 that thrush in newborn infants may be secondary to infection of the vagina. 



k. Pruritus ani. In cases of severe itching, when one notes considerable 

 maceration around the anal orifice, M. albicans may be the cause. 



More than one of the localized types of infection may be present in the 

 same patient. 



(2) Moniliids, or levu rides. —Sterile vesicular lesions on the hands and 

 localized or widespread erythematous vesicular exudative patches caused 

 by dissemination through the blood stream of products of M. albicans have 

 been described by Ravaut and others. According to Hopkins, certain cases 

 of miliaria are due to M. albicans. The condition is probably a moniliid, 

 although Hopkins found the organism in some of the lesions. A focus may 

 be found elsewhere on the skin, but according to Hopkins the gastrointes- 

 tinal tract is a frequent site. The diagnosis of moniliid of the hands is 

 similar to that of trichophytid. Sometimes the absence of a fungous focus 

 on the feet will make one suspicious of moniliid (rather than trichophytid). 



