A 14-year-old girl presents with vaginal itching and cottage cheese-like discharge. The symptoms are new, and she has not been sexually active before. What is the most appropriate course of action?

• A. Refer to the GP for urgent appointment within 48 hours
• B. Provide an over‑the‑counter antifungal
• C. Advise on vaginal hygiene and recheck in a week
• D. Prescribe an oral antifungal without examination

Answer: (A)

When a young adolescent presents with new vaginal itching and a cottage cheese–like discharge, the best course is to arrange a prompt clinical assessment to confirm the diagnosis and rule out other conditions. Although candidiasis is likely, discharge in this age group can have several causes, and a healthcare professional should evaluate, examine, and, if needed, perform tests to ensure safe and appropriate treatment. This is especially important in minors, where confirming pregnancy status, STI screening considerations, and correct therapy are essential before starting treatment. Referring for an urgent GP appointment within 48 hours allows a clinician to take an accurate history, perform an examination, and provide targeted therapy if candida is confirmed or manage other causes if not. Self-treatment with an over-the-counter antifungal could mask or delay a more serious or different diagnosis and is not the preferred approach in this scenario. Guidance on hygiene alone and delaying assessment risks ongoing symptoms and missing other conditions.