Managing persistent thrush

Persistent vulvovaginal candiasis, or recurrent thrush, is defined as the occurrence of four or more episodes of thrush within a year. Persistent thrush is caused by a fungal infection called Candida albicans. This is said to be the causative organism in 80-92 per cent of cases. Other causes are C. glabrata, C. tropicalis, C. parapsilosis, C. krusei, C. kefyr, C. guilliermondii, and Saccharomyces cerevisiae.¹

Susan was a 42-year old patient who attended my surgery, initially stating she had a probable urine infection. Initially, she was reluctant to describe her symptoms. Susan had visited the surgery for a smear test two years previously and had found the examination stressful.