This condition, caused by candida albicans, may occur even in healthy neonates from the infected birth passage during delivery, infected feeding equipment and prolonged antibiotic therapy.
The lesions, usually preceded by redness of oral mucosa and tongue, are characteristically discrete whitish patches/spots over the tingue mucosa, gums and lips; extension over to the posterior oropharynx may occur, leading to swallowing difficulties. Involvement of the perianal region is frequent, so is the monilial diarrhea. The lesions are difficult to be removed by scraping.
Response to local application of gentian violet (0.55), nystatin (2,00,000 units/5ml ), or cotrimazole, after each feed, is gratifying. A 5 to 7 day course suffices.