Low prevalence of genital candidiasis in children

In order to determine the prevalence of culture-proven candida infection in children with genital symptoms, a retrospective case-note review was performed to identify all symptomatic children with a culture result positive for Candida spp. during a 15-month period. Between May 2000 and July 2001, a total of 570 specimens were received from 473 children, and 34 positive culture results were recorded for specimens taken from 32 patients. Of these patients, 19 were in the 0-3-year age group, six in the 3-9-year age group and seven in the 9-12-year age group. Underlying risk factors for infection included prematurity, immunosuppression and prior antibiotic therapy. Three children were suspected to have experienced sexual abuse. Candida infection is uncommon in toilet-trained prepubertal girls, and empirical antifungal therapy is not indicated in this age group unless there are well-recognised predisposing factors. If a Candida sp. is isolated from a genital tract specimen taken from a 3-9-year-old girl, then a specific cause needs to be sought.