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Mic-key site irritation (Site care, gastrostomy button, yeast infection)

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Question

This child is experiencing irritation around her Mic-key button site. It has the circumference of a baseball, raised and red/bumped around perimeter and seems to be spreading. It looks like a reaction to something. Could silicone produce an allergic reaction? GI doctor thought it was a yeast infection and tried to treat it with Nysatin, which had no results, and also thought that gastric juices may be leaking and causing irritation. The child was put on Prevacid. Nysatin creme has since been stopped. The pediatrician did not agree with a diagnosis of yeast infection and started her on a topical antifungal creme called Mentax

Does this sound like anything treatable to you?

Answer of our experts

Yeast is probably the culprit. Yeast likes wet and warm environments. We use Nystatin powder and keep the site dry. It is best if they can do without a dressing. The acid blockade is a good idea CP/ TK 7-13-10

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Recommendation(s)

Feeding and Dental Difficulties

R12
In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
R13
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
R14
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
R15
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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