alternaria

[kathyw]

I have had alternaria cultured from sputum on two different occasions.  I have chronic sinusitis and a small area of bronchiectasis.  I also work in a school that recently had to be closed for mold problems. I have brown drainage from my sinuses and occasionly cough up the brown junk. I have written about this problem before and appreciate your response.  I went to a teaching hospital near my home and the doctor there has me trying nebulized ampotericin B twice a day. I think this is experimental so I'm kind of in the dark. After the 1st day I started coughing up the brown junk again. I did this for 5 days and stuff came up in the morning and night.  But then I started feeling awful.  I don't know if this is a "die off" reaction or if the medicine is making me sick. I'm afraid to keep using it but also afraid to stop.  My head feels like it is going to burst, I've had vertigo and I have a fluttering type sensation in my chest in the area of bronchiectasis;  basically I am miserable.  My pulmonologist is out of town for 2 weeks and I haven't been able to contact the doctor who prescribed this. I have been on and off antibiotics since July when I really got sick.  I started taking Avelox and gobs of the brown junk came out of my head.  It is unusual that it doesn't come out until I take an antibiotic and then I have to rinse it out with saline solution. I've contacted my primary care doctor and he doesn't know what to do--put me back on Zithromax.  Any input would be appreciated.

[National Jewish]

It is very difficult to make a diagnosis and recommend treatment for such a complex problem through a forum.  It sounds like you have an infection that is actively going on.  Whether this is in your lungs, sinuses or both is difficult to say without further evaluation.  The same can be said for the symptoms you are describing after the inhaled medication.  It is difficult to say whether this is the result of an infection or a medication side effect.  If this is acutely worse, I would suggest seeing another pulmonologist and not waiting two weeks before a better diagnosis and treatment plan can be reached.