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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #16

Have a pediatric patient complaining of urinary symptoms? Check a urine (obviously) but make sure to examine their genital area.

If the urine is normal, usually candida is to blame. This typically affects females but also can occur in uncircumcised males. You will often times find erythema, irritation, and scant white discharge in the vulvar area in females and around the peniles glans in males.

My go to prescription is a combination cream of nystatin 100,000 units and triamcinolone 0.1% cream. The trade name for this is Mycolog II. Most insurance plans will not cover it, so write it as 2 separate creams and have the patient mix it themselves.

Symptoms usually resolve in 2-3 days.

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