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Fungal infection

First of all, I am a male, in his mid-40s, who is relatively healthy except for a positive diagnosis of Hepatitis B (but that is not what this post is about). I have been dealing with what I believe is a fungal infection since beginning of August. I had a sexual encounter a week before that. It was with a woman I did not know very well. We had sexual intercourse with a condom, and there was no oral sex. I asked her to penetrate anally, to try something new, and she did that, while wearing some kind of latex glove. We were in her bathroom which was wet from a shower.

Anyway, about a week later, I experienced a redness and itching at my penis head and anus, which also affected my left leg and foot. The left leg and foot also itched, burned, and tingled, although there were no outward signs of any lesions. I immediately went to the doctor and had a full STD panel of tests done - Chlamydia, Syphilis, Gonorrhea, Herpes, Trichomoniasis - all came back negative.

The pain in my left foot got so bad I could barely walk or stand. I bought Clotrimazole cream from the pharmacy and applied on my penis and anus, and suddenly the left foot no longer tingled or had pain. I followed the directions for a few weeks applying the cream twice a day morning and night. I also used Apple Cider Vinegar as an anti-fungal wash. By the time October came, I was symptom-free in my foot and my groin, so I put it all down to a fungal infection of some kind.

October was great, I was back to normal. Then November came, and the leg/foot pain came back with a vengeance. I had slacked off on using the Clotrimazole because of the lack of symptoms, although I was still wiping my skin with the Apple Cider Vinegar.

Now it is Nov 23, and I have been plagued with left leg and foot pain. It is not as bad as before when I could barely stand, but it is still there, and the fact that the pain is still there means I still have a fungal infection.

Recently, my doctor said I have a candida infection, and gave me Diflucan (flucanozole) to take for 10 days. I just finished it and there was no apparent effect. Now, I'm not so sure it is a fungal infection. Urine and blood analyses done back in August showed no bacteria in the blood or urine. Could it still be a bacterial infection?

I am still going through various anti-fungal topicals - Clotrimazole, Miconzole, Tonaflate, etc. and they work to some extent, but the pain doesn't completely go away like it did before. I even started taking Caprylic acid supplements.

Any ideas on what else this could be besides a fungal infection? If it is a fungal infection, what other treatments are there? Enemas? Nystatin?

Thank you.

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1415174 tn?1453243103
COMMUNITY LEADER
Welcome to the Infectious Disease site. I am a microbiologist not a doctor. But have some knowledge of these types of problems.
Hi, so what kind of urine test was it? Was it a urine culture or just a regular urine test. If it is a fungal infection a lot of yeast and fungi are resistant to the anti-fungals that end in azole. So you could have one that is resistant. A over the counter cream called Terbinafine (Lamisil) usually is still good against many of these resistant strains. But you have to use it as directed on the box or package insert. It is something like 2-3 times a day for about 1-2 weeks. If it doesn't clear up after that you may want to see an infectious disaese doctor or a dermatologist. I would say maybe a dermatologist.You can use it externally on all the areas you mentioned. So it is good for the groin area, penis area, also for feet and other topical skin areas.
mkh9
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Avatar universal
Its pinworm. A parasite..the worm comes out and lays eggs on the anus and crawls back in..the women needs to be treated to. The medicine anzole or metronidazole or along that line. Im just now investigating it myself. I was I was at a nursing home and there was this lady she was dying and she was a hundred and one years old and they have the toilet quarantine and I had already used the toilet so I caught these things from this old lady there pinworms or threadworms
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1 Comments
Anazinole??? **** i cant remember.
1415174 tn?1453243103
COMMUNITY LEADER
Great news.
mkh9
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Avatar universal
Update: seems my fungal infection is getting taken care of by the repeated use of the 2% Clotrimazole, that I have been applying. No joint pain, no other symptoms, except for glare in vision and mild vision haziness.
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1 Comments
Unbelievable. Your lucky one of them worms didnt crawl up your anus. This is where guys have the advantage but these pinworms can reek havoc especially if alleridvto what they let off or worse some autoimmune response. Good luck buddy. Hope you get to the gut of the problem. No punt intended❤
1415174 tn?1453243103
COMMUNITY LEADER
Glad you have a doctor you like. Hope he helps. You sound like you are on the right track.
mkh9
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Avatar universal
I saw the new rheumatologist yesterday and he was really good. He looked at my scrotum which was very red and itchy. He also concluded fungal infection. As to why it has persisted for eight weeks, he doesn't know. But to be truthful, I used a lot of topicals but not consistenly. I used Clotrimazole+Bethamethasone cream for a week, then switched to Clotrimazole+Betamethasone lotion for another week, then found out I shouldn't be using Betamethasone at all. So, I started using Ketoconazole for a couple of weeks, and found out it wasn't really effective. So I used Nystatin for another couple of weeks, and found out it wasn't really effective. Finally, I went back to 2% Clotrimazole without any steroid and it did seem to work better than the others. The Clotrimazole I initially used worked well too, but I didn't know if it was due to the steroid or to the effectiveness of the Clotrimazole. Turns out, the Clotrimazole was the topical that worked best for me.

As for why I had the scrotal itching flare-up last week - I have a confession to make. I started using, in addition to the 2% Clotrimazole, the leftover Erythormycin gel the dermatologist gave me, and it caused a severe rash and irritation. It did that to me before. That's why I had so much leftover. Well, I guess I didn't learn my lesson. On top of that, I also used tea tree oil, clove oil, and neem oil on the scrotum to experiment (this was because I was certain I had scabies or crabs). I guess what they ended up doing was irritating my scrotal skin even more. Hence, the intense burning and itching at the scrotum I wrote about in my last update.
As of today, the scrotal itch and redness lessened greatly since I went back to strictly 2% Clotrimazole and nothing else. It took about a week to be off of all that other stuff for my scrotal skin to quiet down, and it is considerably better. I also think my blanket is re-infecting me, as I use the same blanket every night and it is a wool-type blanket. I think the Clotrimazole does work, but I need to use it and nothing else for at least four weeks, which is something I have not done since all this started. I was jumping from one topical to another too quickly.

As for the new rheumatologist, he said that the pain in my fingers and joints could actually be a type of reactive arthritis. He concluded this after I told him that when my finger was very sore and stiff a couple of days ago, one pill of Bactrim/Sulfamethoxazole cleared the stiffness and pain within the hour.

I like this new rheumatologist. I get the feeling he will work with me to resolve this. Although his specialty is joints, he was willing to look at the scrotum and other symptoms to see the big picture as to my condition. He said it doesn't look like a scabies infection, but I can go ahead and try the Permethrin - it wouldn't hurt. The fact that Sulfamethoxazole cleared up the pain for the first time in weeks tells me that this joint pain is not indicative of permanent damage (hopefully). Could the Sulfamethoxazole be anti-fungal as well? I thought it was only for Staph or other bacterial infections. Or maybe I also have a bacterial infection.
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1415174 tn?1453243103
COMMUNITY LEADER
I would wait for a diagnosis. Don't medicate any more that has gotten you into more trouble than it has helped you. That is my opinion. If you are still putting vinegar on the scrotum I would stop that as well. It is an irritant.
mkh9
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Avatar universal
Part of the problem is the doctors don't think I have anything. The dermatologist won't do a skin biopsy, and she is all upset that I'm not taking HER seriously. Meanwhile, I am in great pain and discomfort. Other doctors think it's a fungal infection and with the ineffectiveness of all the prescription drugs, they are drawing a blank. I do not want to take Permethrin yet for scabies until I know for sure that is my problem.
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1415174 tn?1453243103
COMMUNITY LEADER
Well, I am talking about in the laboratory it is easy to diagnose. I understand it could be harder for the doctor to see what the skin problem is. But for Clinical Laboratory Scientists like me it is fairly easy to see once they have the Scabies skin scrapings. Hope the visit to the doctor helps.
mkh9
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Avatar universal
I heard the opposite about scabies - that they are often misdiagnosed because they do resemble a number of other skin conditions. Usually adults only have 10-15 scabies so a skin scraping could miss one. And if you are looking for burrows they can be very small and itching would eradicate the burrows so they could be missed as well.

I also don't have a lot of confidence in the last dermatologist I saw. She already made up her mind that I don't have anything, including fungus. Even the urgent care doctor that I saw said he disagrees with her diagnosis about the erythrasma. I may need to see another dermatologist, but in the meantime I have an appointment with an infectious disease specialist on Monday.

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1415174 tn?1453243103
COMMUNITY LEADER
Hi mil1209
well scabies is easy to diagnose. Either they see the scabies under the microscope or not. They have a particular look. But your description sounds like eczema. I have it on my legs and hands sometimes and it itches so badly I want to tear my skin off. But I don't even touch it because the more that you touch it the more it itches. Allergies are one reason for eczema. And, not drying yourself well enough is another. Then after drying yourself after a shower putting on a fragrance free lotion right away helps seal in moisture.  I use Cetaphil restoraderm.  But that is for my legs, arms face and hands. In addition, I use another cream for my hands and I wear gloves any time I need to wash dishes or get my hands wet. I try not to wash my hands as much as possible. So I use a lot of nitrile gloves. It is costly for us.  I only got this a couple of years ago along with an allergy to many topicals. I never had all these allergies until the last few years. So maybe that is what is going on.
mkh9
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Avatar universal
Thanks, mkh9 for all your input.

My scrotum itched insanely bad last night. Nothing helped - Clotrimazole, Nystatin, etc. I slathered a ton of Vaseline on the groin area and it helped a little. My skin at the groin is very red, looks like rash or eczema. My left thigh also got red and itchy, as well as the skin of my lower belly right at the belt line. I could feel a small bump at the belt line, and small bumps on the scrotal skin - these bumps itched like crazy when I touched them.

So, I believe what I really have is - scabies!
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1415174 tn?1453243103
COMMUNITY LEADER
Yes some yeast and other fungi are resistant. I think I mentioned that a while ago. Terbinafine (Lamisil) is another good one. Hope the Clotrimazole works for you.
mkh9
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Avatar universal
I went back to the urgent care doctor yesterday, the one who prescribed Terfinafine. He gave me a prescription for 2% Clotrimazole cream. I used it, and the scrotal itch went away for the most part.

So it appears to be a fungal infection. It was just resistant to the other topicals I tried - Nystatin, Ketoconazole.
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1415174 tn?1453243103
COMMUNITY LEADER
When my opinion is that the internal medicine doctor is right that if the metal values were not at medical unit values that would entail a clinical significance then there is nothing to worry about. It did seem extremely odd to me. So I'm going with that. I'm glad the other issues have cleared up. often when you have had an infection or dermatitis or whatever was causing your scrotal problem and have inflammation afterwards, It can be very irritating . Adding vinegar and witch hazel to such a sensitive area may only aggravate it. I would get the gel that they recommended to sooth the area and leave it alone until it heals.  So the symptoms point to irritation and inflammation at this point.
take care,
mkh9
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Avatar universal
Hello,

Well I am getting conflicting reports from medical professionals again.

I saw a MD about the elevated levels of metals in my blood and she said it is not really something to worry about. My level of Lithium is still much lower than bipolar patients taking Lithium as a drug. As for the level of Platinum, the doctor said even at 0.2 ug/L it is an acceptable level. The problem is the range values the forensics lab used. They are off and not a standard medical range of values.

She also said to take NAC, same as what the forensics toxicologist told me to take. This MD is not a toxicologist, but rather internal medicine who has a lot of experience with chelation therapy.

All the other metals found in the forensics test are not alarmingly high, and can be found in most people. I am due for a metals re-test, but since this will be ordered by a doctor it will be done in a medical lab this time and not a forensics lab.

As for my symptoms, some things have gotten better. My vision has really improved, and my eye doctor was glad to hear about that.

My joint pain has also gotten much better. I no longer limp and for the most part am pain free. There are some lingering pains here and there, namely in the fingers but not nearly as severe as before.

As for the scrotal itch, it continues with severity. I went to see the dermatologist who stated I had erythrasma or corynebacterium minutissimum bacteria infection on the scrotum. She prescribed Erythromycin gel to be applied topically on the scrotum. In a follow-up visit to her, a Woods lamp was used to detect the bacteria and there was none. Could be that the gel took care of it, or maybe I never had it in the fist place.

Another doctor doubted I ever had corynebacterium minutissimum, which would not cause the severe itching and pain in the scrotum as I experienced. Instead he looked at the scrotum and said I had a bad fungal infection, and prescribed Nystatin cream, Nystatin powder, and a 14-day course of Terbinafine, 250 mg per day. It was a strong regimen, but I finished it and still have the severe scrotal itch.

The dermatologist, in my latest visit with her, did do a skin scraping of the scrotal skin and went and looked at it under the microscope while I waited. She came back and said there was no fungus. This was after I finished the Terbinafine course.

So, bacteria and fungi are not the causes of my scrotal itch. I don't know what it could be then. I then asked the dermatologist if it could be scabies or crabs and she said no. I had no red bumps.

Currently, my scrotal symptoms are thus: when I run my fingernail slowly over my scrotal skin, I could feel tiny bumps on it. To the eye these bumps are hardly visible and are not red or swollen. Yet they are there. And when the fingernail makes contact with the bump it hurts like crazy. It also sends a jolt down my left leg to my foot. I have tried to show these bumps to the dermatologist but because they are so hard to see she did not think much of it, and said my scrotal skin looks normal. She also said the itching is only due to what she called an itch cycle from inflammation, and said for me to only use Elidel from now on, for as long as I needed to. I haven't gotten the Elidel yet. In the meantime, I have been using witch hazel and apple cider vinegar to wipe down the scrotum. It burns upon contact, but I think it does help to lessen the itch. As long as I don't touch those bumps, the itch is minimal.

What do you think these scrotal symptoms point to?







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1415174 tn?1453243103
COMMUNITY LEADER
That is pretty scary. Well, I hope you recover soon and feel better after that.
mkh9
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Avatar universal
The toxicologist said had I taken more than 3 days of it, I would not be around now. He said the stuff could kill a dog.

The ingredient list ofr the zeolite only lists 1 item. Maybe it got contaminated.

Anyway, at least now I know why my fungal infection continues despite various meds, and why I still have these symptoms.



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1415174 tn?1453243103
COMMUNITY LEADER
Wow. that is awful. I haven't seen anything on the ingredients of zeolite only that it is used in a variety of things. I would still get another test to double check. But that is up to you if you trust the results. If they are correct then you do need to clear this from your system.
mkh9
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Avatar universal
I talked to the toxicologist this morning. He said the lab analyzed the zeolite too. He said the zeolite is a very dangerous substance and I am to stay far from it. They found Thorium, Cesium, Lead, Barium, Stronium, etc. More than likely the zeolite is the culprit.

The toxicologist said for me to take NAC (A-Acetyle Cisteine) for 2 months, 600 mg tapsules 2X a day to remove the metals. He would like for me to get tested again in a month for metals levels. He said that should take care of the metals and I should make a recovery. He is however, not a medical doctor but a forensic toxicologist.

I have an appt with a toxin specialist on Friday who is a medical doctor. Hopefully, she will devise the right treatment.

My primary care doctor said this morning that the fungal infections are persistent due to the presence of contaminents in my system.
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1415174 tn?1453243103
COMMUNITY LEADER
I have read that too regarding chemo . But since you haven't had chemo it doesn't fit. I wonder if the lab results are correct. It sounds like you live near a toxic dump that was there in the past or something? I wonder what the doctor will say?  Personally, I would repeat the test at another lab. Just to be sure.
mkh9
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Avatar universal
They also detected arsenic in my blood.

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Avatar universal
I have done some research and found chemo drugs for cancer have platinum in them. But I sure as heck never took those, at least to my knowledge.
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1415174 tn?1453243103
COMMUNITY LEADER
Sorry I am wrong about nuclear reactor I was thinking plutonium not platinum. Disregard the last statement.
mkh9
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