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A matter of tact: Vaginal candidiasis

Vaginal candidiasis, or thrush, can be an embarrassing subject to address. Here, Alan Nathan advises on the causes and treatments of this common, yet easily treated, condition

A young woman wants to buy a fluconazole capsule but has not had it before. When you ask her why she wants it she says that she thinks she has thrush. When you ask her how she knows, she says because her friend has told her that’s what it must be.

You ask her to describe her symptoms. She tells you that for the past two days she has had intense itching inside and outside her vagina. She also has a thick, creamy discharge but, in response to your question, says there is no unpleasant odour. She experiences some burning on the outside when she passes water.

Replying to further questions, she tells you that generally she feels well, has no fever or other symptoms, but she has just got over a nasty throat infection and about a week ago had a prescription for amoxicillin dispensed at your pharmacy.

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