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A well child with prolonged oral thrush: an unexpected diagnostic journey
  1. Eleni Gounari1,
  2. Reem Elfeky2,3,
  3. Lea Ghataore4,
  4. Nadia Muhi-Iddin1,
  5. Charles R Buchanan5,
  6. Ved Bhushan Arya5,6
  1. 1 Department of Paediatrics, East Sussex Hospitals NHS Trust, St Leonards-on-Sea, UK
  2. 2 Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  3. 3 Immunity and Transplantation, UCL Great Ormond Street Institute of Child Health, London, UK
  4. 4 Department of Clinical Biochemistry (Viapath), King's College Hospital, London, UK
  5. 5 Department of Child Health, King's College Hospital NHS Foundation Trust, London, UK
  6. 6 Faculty of Life Sciences and Medicine, King's College London, London, UK
  1. Correspondence to Dr Ved Bhushan Arya, Department of Child Health, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK; vedarya{at}


Oral thrush is a familiar presentation in both general practice and paediatrics, and is usually responsive to treatment in the community. Here, we present the diagnostic journey of a previously well boy aged 3 years who presented with treatment-resistant thrush and describe how ‘unexpected’ results led to eventual diagnosis and management. This intriguing case was managed jointly by district hospital general paediatric team and tertiary hospital specialist teams.

  • paediatrics
  • endocrinology
  • allergy and Immunology

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  • Contributors EG collected the data and wrote the manuscript. LG performed the laboratory investigations and critically reviewed the manuscript. RE critically appraised the manuscript. NM-I critically appraised the manuscript. CB critically appraised the manuscript and conceptualised the idea of manuscript. VBA wrote the manuscript, conceptualised the idea of the manuscript and is guarantor of this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.