>....vaginal candidiasis said that
>up to 10% of cases were caused by Candida glabrata and Candida
>tropicalis (rather than the commoner Candida albicans). She is quoted
>as saying that they are less pathogenic but completely resistant to
>normal topical anticandidal agents.

Hi Fiona,
It is probably more true to say that they MAY be resistant to normal
topical agents. BTW Candida krusei is resistant to fluconazole, but the
rest are usually susceptible to fluconazole. I prefer fluconazole
(Diflucan) to ketoconazole b/c of very low risk of side-effects.
Do these other candida occur on the nipple/breast? I think the majority of
infections are going to be C. albicans b/c the infection is often
transferred from the baby's mouth. When I have been taking swabs from the
nipple (which I don't recommend doing routinely -b/c nothing usually grows)
occasionally the result comes back *candida species* - meaning it is not C.
albicans and the lab doesn't bother to type it further. Once I found
Rhodotorula rubra - this poor woman had very persistent symptoms (but who
knows if there is a connection?) - this was a few years ago, pre-fluconazole.
BTW, I have been *surfing* today too: there is an article on Medscape about
the use of fluconazole in paediatrics at
<http://www.medscape.com/Medscape/public/MP/98/0130.html#09>
(I happened to notice an ad for Pzifer at the same site... ?coincidence, I
wonder).
Lisa Amir
GP / IBCLC in Melbourne, Australia