After 2 weeks’ treatment, the breast pain got worse. The areolae were swollen and slightly abraded (Fig. 1). Further enquiry revealed that Ms. Lovely had switched to a larger breast shield for a week after heeding her friend’s advice that the breast pain might have been due to an under-sized breast shield. Observation of her pumping showed that the breast shield was actually over-sized. Too much areola was pulled into the tunnel resulting in areolar swelling and abrasion, which might have aggravated the Intraductal Candidiasis. She was advised to use an appropriate-sized breast shield to prevent further nipple trauma. DaktacortÒ (2% miconazole cream and 1% hydrocortisone) and topical mupirocin ointment were prescribed. Follow-up a week later showed good healing of the areolar lesion but her breast pain reduced only slightly. A 2-week course of oral anti-fungal (fluconazole) treatment was given after which she had complete recovery.


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1. Early identification with timely management of breast pain can prevent early cessation of breastfeeding.
盡早診斷及治療乳房痛症，能預防過早斷奶。

2. Diagnosis and management of Intraductal Candidiasis is a controversial issue. Diagnosis relies more on the clinical presentation than microbiological testing.
乳管真菌感染的診斷及治療是具爭議性的醫學課題。醫生多會依據臨床表癥而非微生物檢測來診斷。

3. To minimize over- or under-treatment of Intraductal Candidiasis, a systematic approach to excluding other differential diagnoses of breast pain is important.
醫生在診症時，有系統地考慮其他乳房痛症的可能性，是減少過度或錯過治療乳管真菌感染的重要門徑。

4. Mother with Intraductal Candidiasis is safe to breastfeed.
哺乳媽媽若患上乳管真菌感染，繼續哺乳仍是安全的。