Fluconazole fungal infection

[MS_1234]

Hello, I've had a spate of itchiness that's lasted around 4 months in genital area, tested for STDs all negative. Doctor unsure as no obvious rash, prescribed 4 weeks of fluconazole to see if it is a fungal infection, 50mg every morning for 4 weeks.

Now the itching is still present 3 weeks in, would you expect the itching to have subsided by now? I'm unsure how this drug works.

Also I seemed to develop a small red rash whilst on these tablets that comes and goes?

Regards

[mkh9]

Hi, We are not doctors on these forums but I am a microbiologist and will try to help. Did the doctor think it was a fungus or a yeast? Did they culture it? Is it on the outer skin or inside? I think the drug may have made you sensitive or allergic possibly. You can try another type of drug that is not ending in azole as the fungi get resistant to these. One is Lamisil (terbinafine). It is an over the counter cream (topical) or maybe they have a spray. Use it as directed. Usually 2-3 times a day externally for about a week or week and a half. Are you a man or woman? Is it external? If not you can't use this internally. But they can give you different medication. But I can talk to you about that if it is internal. But you should tell your doctor that the medication didn't work and you may have become allergic to it.
regards,
mkh9

[MS_1234]

My story is a long process of trying to get rid of this problem so I'll try to summarise, I am a man btw...I developed a random itch in the pubic area back in July, there was no obvious rash that would indicate a fungal infection but I was told to use clotrizamole to see if it was fungal, I tried the cream and the problem seemed to worsen, I applied the cream to the scrotum and anal areas also which resulted in severe itching/burning, what I didn't realise at the time was that I was probably allergic/having a bad reaction to the cream which has now lead to what looks like dermatitis/eczema of some sort on the scrotum but not in the pubic areas. The scrotum and anal areas seem to have settled but the original itch in the pubic area really doesn't want to shift.

After returning to the doctors they were stumped as to what it could be, with no obvious rash they where skeptical it was fungal but prescribed the fluconazole for 4 weeks as a test to see if it did remove it, I presume this method of fluconazole 50mg for 4 weeks would treat yeast also? No cultures or scrapings have ever been taken, they've referred me to a dermatologist but there's a 2 month wait and no obvious skin issues.

[mkh9]

Hi, thanks for the background it helps. I doubt it is a yeast and yes you probably were allergic to the original medication. So now you have a dermatitis type of problem and probably never got over the fungus. It is probably a jock itch type of thing. If it itches a lot you can try the terbinafine (Lamisil) but if you can avoid using anything until you see the dermatologist that would be best. So it doesn't look red or peeling before the dermatitis occurred? Just the itch? I doubt it is a yeast.  But Terbinafine can work on Candida (yeast).
Hope it helps.
mkh9

[MS_1234]

It's hard to remember unfortunately exactly what it looked like etc but I don't remember it being red at all, there's never been peeling like I said the first issue was in the pubic area, there may have been a red patch or so but definitely nothing that was rash like.

Is fungus easily spread?
In terms of yeast? How is this diagnosed? There are no signs on the head of the penis, just the red scrotum and itchy pubic area, this consistent with yeast?

The rash has gone down, but I'm trying to work out if it's in coincidence with me having a higher intake of sugars / coffee which I've been trying to reduce as I've been away on holiday and indulged a little more.

I forgot to mention I've been on antibiotics for a week prior to the fluconazole, this was flucloxacillin, this is used to treat skin infections?

Do fungal infections tend to affect  the scrotum? And if there's no rash is this common?

Sorry for all the questions, thanks for your time

[MS_1234]

Also, if this was a fungal/yeast infection, would 4 weeks of fluconazole usually shift it if it's not resistant? I've seen website say it may need to be Upto 6 weeks but I would of expected to see a huge improvement after being on it for 3 1/2 weeks  

[mkh9]

A fungus is easily spread. You can get it from touching a surface for example you go to the gym and sit on a bench without underwear after a shower and you can get it. Share a towel, step on a floor in the shower and you can get it on your feet. If you touch a surface with your hand then touch your groin area you got it. So you see how easy it is to get it. These are called dermatophytes. You can look them up and see more about them. You can get them on your hair, skin and nails. They feed off of Keratin in those areas. They don't get into the blood or other areas. Yeast you can also get but it is harder to get and usually from taking antibiotics and that is usually in women it is a vaginal infection due to the imbalance of bacteria or anal for the reason in men or women. Usually, it takes a few weeks to get rid of a fungal infection when you use a medication that the fungus or yeast is sensitive to (that works). It usually is gone in a week it is a lot better. You don't always get peeling with it in the groin area. If it is an early infection where you just got it and treated it right away you may not get red or that red.
mkkh9

[mkh9]

How is it diagnosed? Some doctors can just look at it and diagnose it. For fungus like a dermatophyte as I mentioned this probably is they can just tell by the symptoms and what it looks like. For yeast they can culture it or do a molecular test or even microscopic test. It is pretty easy to tell. Most doctors just treat  things.
mkh9

[mkh9]

Fungal infections can affect any moist area where there is contact with a surface or your hands and especially it is humid or moist area like feet (because you wear socks and get in the shower) and the scrotum because it is warm and moist there. So yes it is a place you can get it.
mkh9

[mkh9]

If you read the link I sent. It shows that fungi and yeast are both getting resistant to the fluconazole and other anti-fungals that end in azole so the Terbinafine (Lamisil) is the alternative treatment. It is safe to put on the penis, and groin area externally as a cream or spray. For yeast they can give Terbinafin (Lamisil) or Amphotericin B if you are resistant to the other treatments, but that is harder on you and not a topical or if they have one it would be a prescription. i would try the
mkh9

[MS_1234]

Having had it for four months now, it hasn't particularly spread to the groin or anywhere, it comes in spates, in never really goes away but does ease and then come back with a bang like the past few days have been so bad, really itching. So  you'd say that with taking fluconazole and me still having symptoms that it's either a fungal infection resistant to that drug or it isn't fungal at all? As after a week it should really start disappearing and wouldn't tend to get a huge reaction 3 weeks in?

PCan you test for yeast?

[MS_1234]

Sorry didn't see your other comments before posting message above.

Thanks

[MS_1234]

Thanks for your info. I will try the lamisil cream, is this safe for the scrotum?

Also, I have noticed that the itching seems to subside when I'm excercising, don't know if this is a coincidence but it does seem to happen, it doesn't get worse when I sweat or so it seems. Do you know if it fungal/yeast reacts this way?

[mkh9]

I think it is probably a fungus. Try the cream it should be okay. If you have any problems or questions see a doctor or ask a pharmacist/chemist .I have asked them if it was okay to use the Lamisil on the groin.
Instructions :
For topical dosage form (cream):

https://www.mayoclinic.org/drugs-supplements/terbinafine-topical-route/proper-use/drg-20066273

    
Yours would be Tinea Cruris  (groin) fungal infection. But it gives directions for both yeast and fungal infections. The fungal appears to take longer. You stop using it about a few days after you don't feel symptoms. That is why there is a range of days. You have to wash your hands with each application and towels, underwear daily. Maybe also the pants you wear. It is easily spread . That might be why you got it back off and on.

Hopefully, it will help.

mkh9

[MS_1234]

Thanks I will speak with doctor tomorrow about it.

I have been generally clean and cautious for the past four months, washing hands with soap after busting the toilet, washing towels daily and underwear at 60 degrees plus, as for pants/jeans I haven't been washing these daily so is it possible this is where it's coming back from? For example visiting the toilet, touching the area, re-zipping/buttoning, could I be passing it onto the zip/buttons and so everytime I revisit the toilet and undo it passes back to the genital area? Sorry if this sounds like a stupid question I'm just trying to understand how it keeps reoccurring

[mkh9]

Hi, If you are wearing clean underwear I doubt you are getting it from your pants actually. So, you sound like you are doing the right things. Let me know how your doctors appointment goes.
mkh9

[MS_1234]

Been to the doctors, they've prescribed me a stronger antifungal, itraconazole 100mg for 15 days.

He didn't seem to know what my issues where, he said he'd expect it to be in the creases etc but I've never had that, I've also had sex with a partner and they haven't complained of having any issues which makes me suspect this maybe isn't fungal, what are your thoughts?

One side thing is that the issue seemed to flare up whilst drinking soft drinks with artificial sweeteners, I've removed sugar from my diet over the last couple days and my symptoms have really improved.

[mkh9]

Hi, that is good. Itraconazole is much stronger than Fluconazole . So hopefully it will work. I would have just tried the over the counter Lamisil since it is the alternative to the resistant types but if you want to try the Itraconazole you can. Did you tell the doctor you might be allergic to the fluconazole or that you had a reaction to it? Since it is in the same class of drugs it make cause the same type of reaction. That is why I also suggested the Lamisil. Usually for example if you are allergic to penicillin you can't take any type of penicillin derivative like Cepalosporins (cephalothin, cefoxitin,) Same thing might occur and probably goes for this class of drugs. If you think you really had an allergic reaction to the  Fluconazole and forgot to tell the doctor you might want to call the office and tell them that and see if they still want you to use this since it is in the same class as the other drug.

Yes the doctor is right that the fungus likes creases of the skin. So I don't know how that helps you but it is just information. Sexual partners won't always get fungal infections. So don't worry about it. But I would probably abstain if you can until this is cleared up. It will also cause more friction for you and irritate the area.. It's not an STD but its like athletes foot if you walk on a floor in a gym where others have walked you might get it and then you might not. The same would go for having sex they may or may not get it.  
My husband gets athletes foot much more often than I do. But I wear socks. Also, the more long chain fatty acids you have in your skin the less likely you are to get it. This is partly genetic and partly if you have dry skin.

For this type of fungus I don't think sugar affects it. But it does add to inflammation.

Regards,
mkh9

[MS_1234]

I'm in two minds now as to whether to try Lamisil or the Itraconazole, as for a reaction I'm unsure, it may have been irritation or a small side effect. I will abstain from sex until this is sorted, we've had sex a couple of times but like you say I must not have passed it on unless it isn't instant? It was probably around 7-10days ago the last time.

Do you think this could be yeast at all with the sugar thing? And the symptoms stopping whilst excercising?

Thanks again

[MS_1234]

With a fungal infection would the itching go away for days then come back? That seems to be what I'm having, thanks.

[mkh9]

I wouldn't worry so much about this. Many people get it. No I don't think you passed it to anyone. No I don't think it is a yeast. Why are you worried about yeast? It is not that big of a deal if it was. But I don't think it is. Yes it can come and go like that if it is a fungus. It can also come and go if it was a skin irritation or eczema or other skin issue. But you don't sound like you have eczema and your symptoms sound like fungus. The other antibiotic might have caused a dermatitis. Did the new doctor see the area? If so they would told you one way or the other. It shouldn't hurt to use either anti-fungal. But if you haven't told the doctor you just saw that you think you may have had an allergy to it or reaction you should tell them before using it. So its up to you which you want to try. I can't tell you that. I can only give you information.
mkh9

[MS_1234]

Thanks for the info once again.

I saw a private doctor in the hope to get it sorted, they have seen the area previously and stated it seemed to be dermatitis on the scrotum which is likely to be from the application of the clotrizamole. He said there was no obvious signs of a fungal infection. However the itching is in the pubic area where it started originally not the scrotum, he didn't really inspect this area and the scrotum hasn't been itching recently so this seems to be dieing down.


The itching seems to be much worse over the past couple weeks since coming to the end of the fluconazole cycle, and then finishing the drugs, in particular the past couple of days have been the worst since the original itch 4 months ago. As if the drug has increased the problem?

It was my usual doctor who prescribed me the fluconazole, and then the itraconazole, they've looked before taking these drugs but not since.

The itching seems to die down when exposed to fresh air, but it really is just random itching across the pubic area not the penis or scrotum.

[MS_1234]

How long does fluconazole stay in the system having had 50mg dailyfor 4 weeks? Could I still be having a reaction to it 5 days on

[mkh9]

I dont' know. You would have to ask a pharmacist for that question. But I think it is possible. Not 100% sure though. Usually, an allergy response takes a while to get out of you system in general. It is not the drug that is the problem it is the immune system that still recognizes there was a problem and maybe still reacting to it. I had an allergic response to a topical steroid and it took me about 2 weeks to get my leg that had blown up like an elephant leg to go down, and then it peeled etc. I have never gotten rid of the sunburn like appearance it caused.
mkh9