CASE ONEJAN, 40, has been troubled by recurrent thrush for five years. She has tried many preventive measures, including an anti-candidal diet advised by a naturopath friend. Some vaginal swabs taken over the years have grown candida, but most have shown only normal vaginal flora.Jans main symptom is vulval irritation rather than increased vaginal discharge and, on examination, her vaginal discharge appeared physiological. However, on closer inspection there were also two small vulval fissures near the vaginal entrance. A PCR swab from the base of these fissures gave us the correct diagnosis a week later herpes simplex type 2. CASE 2REBECCA, 19, requested an appointment. Two days earlier she had developed vaginal irritation. A friend suggested she had probably...
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