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June 20, 1986

Ketoconazole and the Yeast Connection

Author Affiliations

Loyola University Stritch School of Medicine Maywood, Ill

JAMA. 1986;255(23):3250. doi:10.1001/jama.1986.03370230056025

To the Editor.—  During the past 12 weeks we have seen in consultation four young women with an iatrogenic illness that we had not encountered previously. In conversations with other infectious disease specialists at other local institutions, we learned of five similar cases during the past six months (oral communication, March 1986). All four of our patients were young women with nonspecific complaints including chronic fatigue, anxiety, and depression. All had normal physical examination findings and screening laboratory study results, including blood cell counts, serum chemistry studies, and erythrocyte sedimentation rates. A unifying feature in all of these cases was that all four women believed that they had disseminated candidiasis and were taking ketoconazole or nystatin, which had been prescribed by their family physicians. None of these patients had any clinical presentations compatible with invasive fungal infection. All had recently read a book entitled The Yeast Connection.1 In fact,