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    Diflucan Prevents Yeast Infections

    Antifungal Drug Suppresses, but Doesn't Eradicate Candida in Most Patients

    Diagnosis a Problem

    Eschenbach writes that the frequent misdiagnosis of vaginal yeast infections and other causes of vaginitis remains a significant obstacle to effective treatment.

    "Successful treatment is often delayed because the causes of [vaginitis], including candidiasis, are commonly misdiagnosed both by patients and physicians -- mainly because the symptoms and signs may be nonspecific, but also because of the lack of inexpensive and accurate diagnostic tests and because of suboptimal medical training. "

    Sobel says as many as 80% of the patients he sees who believe they have recurrent vaginal yeast infections are mistaken. For example, women with vulvodynia, which is a poorly understood condition which causes pain and inflammation of the female genitalia, can be misdiagnosed as having vaginitis. Approximately 30% of women without symptoms have candida yeast in the vagina.

    "They definitely have the symptoms, and many are told this is what they have by their doctor," he says. "But unless a vaginal yeast culture is performed the doctor is only guessing. A woman who thinks she has recurrent yeast infections has to find a competent doctor and demand this test."

    SOURCES: Sobel, J. New England Journal of Medicine, Aug. 26, 2004; vol. 351: pp 876-883. Jack D. Sobel, MD, division of infectious diseases, Wayne State University School of Medicine, Detroit. David Eschenbach, MD, professor of obstetrics and gynecology, University of Washington Medical Center, Seattle.

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