Thanks to all who offered suggestions for the resident with the stubborn
case of mastitis.  Thankfully, she is much improved now that she's on
Diflucan, Keflex and has had a combination of massage, reflexology and
homeopathic treatments (and, no doubt, a real acceptance of the need -- at
least temporarily -- to just rest and nurse her baby).  Now if we can just
convince her not to return to her resident duties too fast......

Now for a quick question.  The possibility that this mastitis was actually
due to yeast was brought up in a couple of the posts.  I had seen "yeast
mastitis" briefly discussed in Lawrence's text and now I'm wondering how
often this occurs in practice.  Those of you who treat a lot of breast
candidiasis, please share with us how often yeast presents as a mastitis
in your experience.  If that diagnosis is considered, what are the
clinical criteria that differentiate it from a bacterial mastitis.  How
often is a culture of the milk helpful in making this diagnosis?  TIA,
Alicia Dermer, MD, IBCLC.

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