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Nasty Yeast
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Nasty Yeast

Tried Fluconazole, Monistat, Terazole for 5 days with only symptomatic relief but does not cure it.
Also my anus is Itchy aftre bowel movement which means its also in my colon.
Recently did a yeast culture test and stool test and susceptibility test but waiting for results and pretty sure it could be C.Glabrata since it is resistant to the Azoles.
Are Echinocandins used for to cure rectal yeast as well ans what is the rate of success?
Also ordered Boric acid suppositories to treat vaginal yeast infection, is it safe to use it rectally as well?
This is getting very very frustrating.

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I would wait for the sensitivity results and identification of the yeast. Even C. albicans can be resistant to the Azoles. Terbinifine (Lamisil) is a good alternative if it is C.albicans. Here is an article on Candida albicans for recurrant infection and treatment. You have to scroll down to find the treatment section. It does mention Boric acid treatment as a possibility but it can cause irritation.

http://www.aafp.org/afp/2000/0601/p3306.html

http://care.diabetesjournals.org/content/30/2/312.long

The second study did show that boric acid suppositories did have a higher cure rate in diabetic patients. Are you diabetic?

Neither study mentions use of boric acid or antibiotics in the rectal area. I assume that if it is a cream such as terbinafine (Lamisil) is may be okay. I would address these issues with your doctor after you read them through. If you have any questions after that let me know.

The Echinocandins seem to create more resistance rather than help. So it is a short term fix then it recurs.

mkh9
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I would wait for the sensitivity results and identification of the yeast. Even C. albicans can be resistant to the Azoles. Terbinifine (Lamisil) is a good alternative if it is C.albicans. Here is an article on Candida albicans for recurrant infection and treatment. You have to scroll down to find the treatment section. It does mention Boric acid treatment as a possibility but it can cause irritation.

http://www.aafp.org/afp/2000/0601/p3306.html

http://care.diabetesjournals.org/content/30/2/312.long

The second study did show that boric acid suppositories did have a higher cure rate in diabetic patients. Are you diabetic?

Neither study mentions use of boric acid or antibiotics in the rectal area. I assume that if it is a cream such as terbinafine (Lamisil) is may be okay. I would address these issues with your doctor after you read them through. If you have any questions after that let me know.

The Echinocandins seem to create more resistance rather than help. So it is a short term fix then it recurs.

mkh9
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I had a swab done two months ago and it came out negative for yeast despite burning and itching sensation and the fact that ever other STD and UTI were also ruled out to be negative.
If it was C.Albicans it would have been detected but Glabrata lacks Hydraphae so cant be detected unless culture is done. I am waiting to hear about the results desperately.
I am not diabetic either but this was definitely passed from someone since it all started Fed 1st week after I was with a guy.
I hope there is a treatment for it as I cant even eat normal foods that have bit of Carbs coz it just aggravates them. Even foods like Brown rice and lentils.
You are a great help here on this board. Please stay in touch..
I have great hopes from you.
Also the doc I am dealing with is a resident. Not saying she dsnt have any knowledge but she wasnt even aware of the different strains of yeast and this was suggested by me to run the culture.
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Let me know when you get the culture results back. Glad to help. It could also be bacterial vaginosis. Usually it is caused by pH in balance causing Gardnerella vaginalis or some particular other bacteria to predominate. These then can cause the symptoms you have as well. They can look for this on a smear plus some other lab tests.
mkh9
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I was prescribed Flagyl500mg BID for 7 days but it only got worse so leaving me with the idea of having yeast.
But I will keep you posted.
Almost feel there is no end to this but I will have to live with this for the rest of my life.
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So it turns out that my Yeast results are -ve and no signs of BV either.
What is it then?  Its very itchy and as I mentioned before, its aggravated by foods that have sugar.
How could it be nothing but just in my head?

Please help me.

I have been denied an appointment with a new doc here because the senior Doc over ride it saying its in my head and its not. Its not legal for them to deny me health care rights.
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Hi and sorry you are going through this. Did they actually test you for BV or just give you Flaggyl? There are other bacteria that can cause BV and may not respond to Flaggyl. But also, could you have have an STD? Trichomonas can cause similar symptoms as well. Of course it isn't in your head. That is ridiculous. I don't know why it is triggered by sugary foods but that doesn't matter. If you have any money you can always go outside the system and tell them you don't have insurance and you want to pay cash. They usually give you a substantial discount. One question is do you douche? If so I wouldn't ever do it again. It offsets the normal vaginal bacterial flora. It doesn't matter what kind. Also, don't put soap up the vaginal canal it will irritate it and cause the same problem. It is self cleaning you can just wash the outer area.   A clinic can test you for Trich if you have had unprotected sex.  There is also a high rate of recurrence with BV and it is best to use a topical or oral probiotic with treatment. One study stated that once weekly topical (vagially) probiotic for 6 months prevented it from recurring. So, I'm not 100% sure it is not BV or that it was cured. I would like to know if they did a smear or other lab test to prove or disprove you had it.

Also, looking outside the box allergies to Chemicals such as perfumes and dyes in detergents, fabric softeners, creams, ointments, toilet paper and sprays may irritate the vagina or the skin around the vagina.

So, now the issue with sugar. Assuming it is a yeast that they didn't identify and sugar intake is aggravating it. Perhaps cut out all white sugar and sugar intake. You get enough in your regular diet. No sodas either.
It does sound like a yeast but it doesn't show up so far. They are easy to see and culture. Let me know what you think about what I have said and we can try to go forward from here.
mkh9
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The very first test done in Feb pointed it could be BV but wasnt very confirmed(dont know if it makes sense but thats what I was told).
Therefore Flagyl was prescribed.
Also Trich is -ve and there is no discharge or odour.
I have money but we have only one clinic and hospital so I dont even have a choice. I can explain you the reason why I cant go anywhere else but cant do it on this forum. Could you please provide me your email address?
I do not douche at all and I do use soap to clean but dont use it up high but just around the area.
How can I use a topical probiotic? Are there creams available with them?
They send a swab from here to the lab so not sure what kind of lab work they d.o to find out if its BV.
I have also tried Cetirizine and Benadryl with no success and changed my laundry detergent to Hypoallergenic one with no success.
Also, sodas/juices or white sugar is not part of my diet at all. Only water with some lemon is what i drink.

PS: thanks for ur time and interest in helping me out. God bless you
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Well, since the test was indeterminate for BV you could try a vaginal probiotic suppository. Just Google those words and you will see a lot of products come up.  You can also take oral ones but I don't think they will work as well for that area. It is worth a try. You can message me on here. I don't give my home email out.
mkh9
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I ordered one of the products from Amazon with good reviews, will keep you posted on my health.
Also thinking of trying some Hydrocortisone0.5%cream for some relief. What do u think?
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I would just try the probiotic for  a while. I wouldn't put any hydrocortisone in the vagina. The tissue is too sensitive and you may end up breaking out more. The face is like this too.
mkh9
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Thanks a million.

Will take your suggestion and God willing everything will be alright..

Cheers
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Is it possible to have BV go undiagnsed after a swab?

Since yeast is -ve, it gotta be some bacteria causing the itch.
Or is it possible to have some kind of virus that is causing only the itch and no other symptoms?
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Yes they can miss it as a false negative. It also depends on the types of tests they are doing.  
mkh9
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Also I forgot to mention one of my results.
Its presence of Blastocystis Hominis in the stools but I never had any diarrhea.
Is it possible to have it on my skin in genital areas causing these symptoms?
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Also, the recurrance rate is high. So that is why you have to  take the probiotic for a long period of time. The bacteria are an indicator of having BV but it is a syndrome that is caused by a pH change in the vagina plus the normal bacteria changes.
mkh9
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What can I request to be tested specifically in order to find out if its is BV? Type of tests?


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Also, at one time my IGE levels were 486KU/L (ref range<120).
BUt at that time I was taking Vermox, coz the doc was suggesting i may have parasites.
But VErmoz didnt do anything but just made the symptms worse I mean itch.
then I was tested again for IGE when I wasnt taking Vermoz and they were back to Normal.
Could IGE have been high from taking Vermox?
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First ask for a test for BV. The is generally just a Gram stain to look for "Clue" cells, lactobacillus, Garnerella and Mobiluncus. But you have been treated with Metronidazole. Clindamycin is the alternative drug. But it has side effects. The other thing is if the they didn't do a PCR or molecular test for Trichomonas vaginalis and just a wet mount (slide test) this is only about 50% sensitive so you a lot of false negatives. You need to find out what types of tests they are going to do or did.

I hope the probiotic works.

mkh9
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Hello

Still no relief but just getting worse with soreness around my anal area now. Its sore all the time and itchy too especially when I am in tight fitted clothes like even Yoga pants, yeast test results are negative but its most likely yeast not getting detected.
It was getting little better for a bit but back for worse now.
Please suggest something.
I tried Probiotic suppository but that only made it worse. There gotta be something for me.
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Hi and sorry you are still having problems. You mentioned previously that you had Blastocystis hominis. Normally, they don't treat it if you don't have symptoms but since you have anal itching, it might be worth getting treated for it. You can try any of these drugs. But Flagyl is the most common if you aren't allergic to it.  Anal itching is one of the symptoms B. hominis can cause when it causes symptoms as well as sometimes diarrhea.

Metronidazole (Flagyl), the combination medication sulfamethoxazole and trimethoprim (Bactrim, Septra, others), and the antiprotozoal medications iodoquinol (Yodoxin) or nitazoxanide (Alinia).  

It may clear up some other problem you may have as well. That is something to think about.

Have you had a chance to retest for BV or Trich using a molecular test? that is all I can think of right now.

take care,
mkh9
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Thanks for the reply.

Never went back to get tested again for Trich and not even sure if they would run that test. But I can check with the doctor again.
This is all I could think of as well is B.Hominis and if it got transferred from Rectum to Vagina during that one incident I mentioned a while ago.
Does it survive in that environment though is my question.
And the mediactions you mentioned, so it could be Flagyl plus the Antiprotozoal  or Sulfa in combination with Antiprotozoal?
I was prescribed Flagyl for the same thinking it was BV but it only made the itch worse I think.
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Maybe it is resistant to Flagyl.  I would talk to the doctor about what antibiotic/antiparasitic. They are now calling it something else and are in transition as to what to call it since genetically it is different then they originally thought when they didn't have all the high tech sequence information they have now. The cyst form can live at room temperature for 19 days. It is also found in animals such as farm animals, and pets. I'm not sure that is what is causing this but since it was found then it is possible since you are having symptoms and they didn't find other things. So it is worth a try.
mkh9
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This all makes more sense now, I did more research on badbugs.org and all the flare ups are caused by diet high in carbs and change with diet has an impact on it and it happens each time I try a diet free of any sugars.
And a combo of Paramomycin, Iodoquinol and Natazoxide for 10 days has been used by many successfully to treat it.
Physicians are not very familiar with it so I am going to have a tough time trying to convince them that it could be the cause of my symptoms.
Thanks a lot
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Well, at least you can try to explain the connection. I hope it works. The problem is Blastocystis doesn't often cause symptoms so that makes doctors think it isn't the problem . But when it does cause symptoms it can be a problem. You can goggle Blastocystis hominis and see the many websites like Mayo Clinic and other sites that say it can be a problem.
mkh9
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I am working on it and going to see one of the new physicians we have here.
Also they can contact the centre of digestive diseases in Sydney Australia(mentioned on their website) to get the treatment sheet. This clinic specializes in treating this parasite with oral triple therapy and also rectaly for more resistant cases.
I am hopeful now and trying to keep my symptoms at minimum by cutting out carbs and sugars. Otherwise it becomes nasty if I eat regular food.

Thanks for ur kind support and expert info.
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That is great. I hope it helps.
mkh9
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Finally, a doc has given me Septra DS BID for 10 days to see if its B.Hominis causing my symptoms.
Took my 3rd dose but havnt noticed any difference in my condition.
Should I give it little more time? Its usually 2 to 3 days before one can notice improvement.
I am so worried and want to find an answer.
Still pondering if the yeast culture result was false negativ
Also is it possible to do vaginal swab test for Hominis? or lab may not accept it?
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Hi, and sorry you are still having problems. But it does take more than 3 days to cure this. Also, Septra doesn't always work. You should take the course of antibiotics and if that doesn't work they may try something else.  That is why they do triple treatment as you mentioned.Usually they do a stool (fecal) culture not vaginal to find the Blastomyces.

Lately, I have become allergic to either soap or latex condoms my husband uses vaginally. So, I don't put soap over the vaginal area and it seems to be working. I was itching badly. I think it is the soap not the condoms. You may try to see if using a different hypoallergenic soap in the anal area, also just to see if it helps.
mkh9
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Hello
I found a great physician willing to work on my case and is considering every possible thing out there.
Re-doing the swabs for yeast, BV and some other things.
In my past tests Vag swab showed high levels of Cococbacilli. What does it mean?
Also WBC count is 11 so a high range, does it indicate an infection or could it be high in healthy individuals?
Also Neutrophils in the high range.
IgE in the blood was also 480 as mentioned before.
All this indicates something is going on.
Any ideas?
I did change soap in the past with no benefit and took Benadryl but no improvement either.
WE are doing IgE,IGA, IgM and IgG to see if its Candida.
Any ideas?

Thanks for your kind advise as usual
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Hi and glad you found a great physician. The High level of coccobacilli is an indication that you might have BV. A bacteria called Garderella is a bacteria that causes BV and is a coccobacilli. It would be good to get your vaginal pH done, a smear done for clue cells and they send a sample to the lab to look for BV.  The WBC count is only slightly high. It could be an indication of bacteiral infection and what they call a "left shift" or high neutrophil count is also an indication of bacterial infection. The Flaggyl usually works on this but half the time it comes back. Don't know why you have a high IgE. That is more allergy related. So, let me know how it goes.
take care,
mkh9
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I will talk to the physician about the above mentioned tests.
Meanwhile, I had swab done and the results are indeterminate for BV and negative for yeast. Also blood work indicates 500KU/L for IgE.
I was diagnosed for B.Hominis in stool so could it be the reason for high levels?
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It seems that chronic parasitic infections can give you a high level of IgE. Is that the only parasite they find? If so it must be causing some of your problems since you have symptoms.  I wonder why your BV result is indeterminate? They must be running your test on a machine instead of by hand and the machine is calling it indeterminate. That means it can't tell if it is positive or negative. They need to do it by hand not machine. I would bring these issues up with the doctor.

1. the IgE value being so high and that you have symptoms so could these be caused by B. hominis  Also, about getting 2 results that are indeterminate for your BV test and ask it is run by PCR or manually.

See if they can treat you for the B. hominis since you have symptoms that won't go away including the anal itching.

I hope they can help.

mkh9
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Yeah, thats the only parasite found in my stools after culture.. But it only started 2 days after that night, if I already had B.Hominis, why did i never had the itching or soreness. He didnt penetrate anally more than half an inch or even less, could that have triggered it and introduced intravaginally?
I bet my IgE was always high but never got tested so there is no baseline.
I am born in India and its quite prevalent in Asia, I have had lots of street food from vendors so its no surprise I was the carrier all this time but why it be triggered only after sex?
There is some missing link here we cant point at obviously.
So if I was to explain it again: He tried to penetrate vaginaly(didnt work) so he tried anal(didnt work), there was also some hand involvement that caused bleeding and then he tried vaginal again. something got transferred from behind  and I believe under the skin when i bled.
I will ask my doctor about the things mentioned above.
Thanks for your time
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Yes, it sounds more like BV.  You had a high level of coccobacilli and that is not normal.  It may not be Gardnerella because you were treated with Metronidazole. They need to do either a vaginal culture or PCR that detects various species of BV. My husband has developed a test like this. It is out on the market but is a research only test that clinical labs use. They could just try a different treatment based on what the culture grows. You are right regarding the B. hominis but it can sometimes be very normal and cause no problems and other times cause symptoms but that wouldn't explain it coming on when it did also wouldn't explain why you have so many coccobacilli. So that needs to be figured out. Normal vaginal bacteria should be mostly gram positive bacilli (lactobacilli) not coccobacilli.
mkh9
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You are very informative and your feedback is always appreciated, thanks a lot.
Sounds like you and your husband have lots of experience and wow thats even amazing that he has developed a test. Keep up the good work to help out people in need, God bless you both.

All of this makes sense and I think in my case its little spread out on the per anal skin and causing it to itch and thats why neutrophils are high.
The itch and raw feeling is external not inside the vagina.
I had started taking Septra DS BID for 2 days only but stopped taking  thinking it was making it worse.
It gottta be a bacteria but I hope we can treat it.
Sure hope there is PCR or hand testing available in Canada.

Will keep you posted
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Also one more question.
Should we do a smear for the clue cells or swab would be alright to find out the causative organism?

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Yes the smear would be fine for clue cells. This would be a vaginal swab. As for the anal area you may want to get an peri-anal swab done but then they might just see it as anal bacteria. Are there blisters on the outside of the anal area or crusting looking? I am wondering if it is the staph that is causing the problem there. It could be two problems. If it is you might want to try a topical like a triple antibiotic ointment only on the peri-anal area NOT the vaginal area.
Yes my husband works at a biotech and makes kits for womens health. He has a Ph.D. in Molecular biology. I am  a microbiologist.
mkh9
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There are no blisters but only felling raw and sore, especially yesterday and today. Would Staph be something to consider if there is no blisters?
I was looking at several treatments for BV, how is Rifaximin for the spectrum and also Tinidazole?
Are they better then Metronidazole?
Also to mention here is the fact that my situation gets worse when I am wearing something not so breathable like Jeans or Sweat Pants. So when I go running it becomes little worse as if from sweating and lack of air. About a week ago I went camping and since it was outdoors, plenty of fresh air and I was dressed loose, resulting in no itch or soreness and then I came home to feeling same old. Yeast has been negative even after culture several times and BV is indeterminate, what kind of bacteria would hide away from Oxygen and fresh air and come right back when given a chance. I eat very very healthy with nothing refined in my diet and despite all that my body cant fight this superficial infection.
Help me please, i am ready to give up anything to be out of this mess.
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They need to measure your vaginal pH and do the clue cells test. Is there is discharge or smell?


Regarding the anal area if there are no blisters or scabs it isn't Staph. Maybe it is a fungus like a dermatophyte which likes hair, skin and nails. Maybe you can try a topical anti-fungal on the anal area. The fungus grows better without closed and moist areas. so it they get dried out they die off . So maybe that is what you have. Maybe you can try Terbinafine spray or cream on it. You would have to use the Terbinafine (Lamisil) for over a week past the time it goes away or it will come back.

It would just look red and sometimes they peel.

The Rifaximin and Tinidazole wouldn't be the best treatment for BV. Tinidazole is another form of the anti-yeast drug you already tried.

mkh9
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No discharge or smell present.
1. I should get the pH and the clue cells test.
2.Yeast came negative several times so I thought it wasnt yeast, but when I took antifungals a while ago they helped only that it came back.
Would dermatophyte not be diagnosed on the swab, as I mentioned before the itch is insie the labia/vainal lips not inside the vagina.
I took a home test a very long time ago for yeast and it was positive but lab tests suggest negative, how is it possible?
I was prescribed Terazole for 7 days, offered some help but came back.
Would Lamisil be any better?
I am thinking of Nystatin Capsules if there is any intestinal involvement and Nystatin Vaginal suppositories(coz there is no systemic absorption).
But also add Itraconazole 3 times a week 200mg Bid to kill the vaginal infection.
What are your thoughts on it?
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Sorry, how about the vaginal infection? Can I use an antifungal cream for it too? Like Lamisil
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I think you may have nailed it finally, It gotta be dermatophytes and it explains the flare ups, site of infection and also the azoles working but it comes back coz azoles dont kill it but Allylamines do.
BV cant affect anus so cross it off, Candida comes out negative all the time, and the swab is taken from inside the vagina and as per my research they woudnt colonize in this area so again comes out negative.
Nystatin would also relieve the symptoms for a while and it comes back.
Lets hope this is it.
Makes total sense
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Am I right in thinking that some Dermatophytes are considred type of parasites and that would explian my high IgE levels?
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think you may have nailed it finally, It gotta be dermatophytes and it explains the flare ups, site of infection and also the azoles working but it comes back coz azoles dont kill it but Allylamines do.
BV cant affect anus so cross it off, Candida comes out negative all the time, and the swab is taken from inside the vagina and as per my research they woudnt colonize in this area so again comes out negative.
Nystatin would also relieve the symptoms for a while and it comes back.
Lets hope this is it.
Makes total sense .
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Yes I think it is quite possible. I hope it works!
Let me know how it goes. It does take a week at least to go away.
take care,
mkh9
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Also, what type of Dermatophytes could be found in swimming pools?
The place we were hanging out belongs to someone working at the pool as a lifeguard for years?
Would it make any difference?
Also the Doc was asking me why the swab test for yeast came out negative if its a dermatophyte? Any thoughts?
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So, dermatophytes are fungi that cause athletes foot and joch itch etc. They are not a yeast. It is different that is why it would negative for yeast. They like moisture so they do hang around the cement near pools and at gym showers and at home in the shower etc. But they are common in the environment. I don't know why a doctor would ask that question. He/she must not be very educated in microbiology. Well if the lifeguard had athletes foot and is barefoot and you sit on the area where he walks you could maybe get it that way but you would have to be naked.  I mean you get it with direct skin contact . So maybe if you touched the cement where the area is and scratched yourself that could do it.
mkh9
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However, Dermatophytes are also tested using the KOH test just like yeast.
Would Lab not make the diagnosis when my swabs were sent in for yeast?
It has to be some deep skin structure Derm infection coz antifungal creams help but does not cure it completely.
Also, I did not know the hygiene practises with it coz i didnt know what I got.

Its with your and God's assistance here we may have an end to this nightmare finally.

I am seeing Doc Tuesday or Wed whenever I get an appt. She is getting hold of ID specialist tmrw coz she wouldnt give me Lamisil without an evidence.
Will sure keep you posted.

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You can't always see fungi on a KOH test for yeast. This because they have to do a skin scraping. If they didn't do that they won't pick up the fungus. Before you used a drug like fluconazole and that is not what you use for dermatophytes that is why I mentinoned  Lamisil (terbinafine). It cures it better than the azole drugs. The Azoles don't work on all yeast and they don't work on dermatophytes well or maybe not at all.  You can buy Lamisil or terbinifine on line at drugstore.com or riteaid.com or CVS.com it is over the counter drug. I wouldn't put it inside only on the surface. But it is good to see what they say.
mkh9
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Thanks.
Its only on the vulva, anal area and the skin around it only when it gets moist from sweating. There is no rash unless I cant see it on the vulva .
How do we scrape the skin in those areas?

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You don't have to. I think you should just try to use the over the counter spray or cream and see if it works. But its up to you. They probably won't be able to culture it unless they took a scraping of the anal area. They can't do that with the vulva. I don't think they would take a skin scraping from those areas.  So I am just thinking that either you let them take a look and maybe they will give you something. But if they don't then it will be worth a try to use the over the counter topicals made with terbinifine (Lamisil)  that kills dermatophytes. Maybe they can tell by looking. I am not a doctor so I'm not good at the non laboratory part of the diagnostics. I do know some as I had to learn some of that but I am just giving you advice and trying to explain.
mkh9
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God bless you for all your help and answering my questions even meaningless with so much patience.
I am certain its what we are thinking it is and just waiting for Doc to call me back afters he talks to ID specialist.
If not then I will order Lamisil Cream from the sites you recommended but I also want Lamisil pills to make sure it eradicates if its under skin structure.
Hope she will help me out.

Thanks again

Will keep you posted either ways..
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Okay sounds good. You may want to try the topical first and see if it works. Oral Lamisil is hard on the liver. If you want to take it and your liven enzymes are okay and have no liver problem don't take Tylenol while you are on it. I think you have to take it for a month. But not sure because I was taking it for  dermatophyte of the toe nail and that may take longer than the skin. usually with a "Jock' itch due to dermatophytes they call it Tinea cruris it takes a week or two of the spray or cream. Just follow what it says on the package. It also causes Athletes foot and that takes about a week and a half. I have had it several times and it itches like crazy and your skin peels. You have to put the cream on several times a day. It does cure it. I hope that is what it is. It totally makes sense to me. But, we'll see. You don't often get it in the anal area but you can get in the groin area so I imagine you can get it there.

mkh9
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