DEAR DR. ROACH: I am a 66-year-old female in good health. In May 2017, my Pap smear showed that I had an infection of Candida glabrata and an itchy fungal infection in my rear-end area. My family doctor prescribed nystatin and triamcinolone cream to treat the fungal infection, which seemed to help, and a six-day Diflucan treatment for the Candida. Once again, my recent Pap shows that I still have the Candida glabrata infection. There is a slight burning in my private parts.

I have a few questions that I hope you can help me with: How concerned should I be about this infection? — E.B.

ANSWER: In medicine, we are mostly concerned about yeasts, such as Candida, and molds, such as Aspergillus. So I think you are talking just about one fungal infection, the yeast Candida glabrata, which is referred to more commonly as “a yeast infection.”

C. glabrata is more resistant to antifungal drugs, especially fluconazole (Diflucan), than C. albicans. So, if you had persistent symptoms, you might be treated with higher doses of fluconazole, a related drug like voriconazole or posaconazole, or with a cream preparation of a drug with better activity against C. glabrata, such as miconazole.

It’s critical to remember, though, that just having Candida (of whatever species) on a Pap smear does not mean there is an infection needing to be treated.