A prospective study of fluconazole treatment for breast and nipple thrush.

BACKGROUND: Breastfeeding women with continuous burning nipple pain, often associated with post-feed radiating breast pain, may be diagnosed with nipple and breast Candida (thrush) infection. This project examined the efficacy of the three fuconazole capsule regime (one 150 mg capsule alternate days) and explored factors associated with longer courses of fluconazole. METHODS: Women diagnosed with nipple and breast Candida and treated with oral fuconazole at a tertiary hospital (n = 96) were followed up until pain resolution. RESULTS: Women took between 1 and 29 fluconazole capsules, mean = 7.3, median = 6. The number of capsules was not related to socio-demographic or health characteristics of mothers or babies; women with more severe breast pain were more likely to take > 3 capsules than women with less severe breast pain. Only minor side-effects were reported. DISCUSSION: Most women require more than three capsules of fluconazole, but two-thirds of women will require six or less.

Congenital cutaneous candidiasis: a case presentation.

When an infant presents in the delivery room with macular and papular skin lesions covering the trunk, extremities, and/or skin folds, the neonatal nurse practitioner covering deliveries must be aware of possible skin lesion differential diagnoses. Among these is congenital cutaneous candidiasis, a rare, usually benign skin infection. If this condition is recognized early, unnecessary testing and treatment of newborns who present with these symptoms might be avoided.

Frequency of peristomal complications.

Practicing wound ostomy continence (WOC) nurses see peristomal complications in their ostomy patient population. The exact frequency and cause of these complications are unknown. Research into problems arising from prolonged use of ostomy appliances is lacking. To ascertain the frequency of peristomal complications, two WOC nurses at a major medical center prospectively assessed the peristomal skin of all new ostomy patients returning for their 2-month postoperative check-up using a peristomal complications tool. The study was conducted from August 1999 to August 2000. Descriptive statistics were used to summarize the data. In the course of the study, 161 new ostomy patients were seen, 10 with peristomal complications, for a frequency of 6%. The frequency of peristomal complications was the highest in people with ileal conduits (five of 34, 15%) and ileostomies (four of 46, 9%). Only one of the 81 people with a colostomy developed peristomal complications. All 10 patients had a retracted stoma. Eight had chemical damage (six with irritant dermatitis, two with pseudoverrucous lesions) and two had Candida infections. Although the study sample size is small, the results suggest that patients with ileal conduits and patients with retracted stomas may require more frequent follow-up visits to monitor skin conditions and pouching modifications.

Neuroscience patients: under attack by fungi.

An intact skin with its acid mantle is the patient's first line of defense. Neuroscience nurses are the patient's second line of defense since they are responsible for assessment and treatment of the skin. Several risk factors make neuroscience patients susceptible to candidiasis. Skin properties, risk factors, assessment, complications and selected nursing and medical treatment of candidiasis are discussed in this article.

Candida albicans and incontinence.

Incontinent patients are at increased risk for developing perineal Candida albicans infection. Effective nursing intervention, antifungal medication, and a moisture barrier ointment can reduce patient discomfort and healing time.

Nursing assessment of the skin and dermatologic lesions.

An accurate assessment of the skin and dermatologic lesions depends on the nurse, who is directly involved with patient care. However, demands of new technology, which supports an increasingly debilitated and aged patient population, makes it more difficult for the nurse to meet high standards of skin maintenance at a time when it should be a priority. Nursing assessment skills need not be extensive but confined to descriptively brief and familiar terms. Basic knowledge of the most common skin lesions allows the nurse to document in accurate and concise terms instead of nondescript generalizations, such as "rash."