Nasty Yeast

[okra85]

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.

[mkh9]

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

[okra85]

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..

[mkh9]

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

[okra85]

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?

[mkh9]

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

[okra85]

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.

[mkh9]

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

[okra85]

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?

[mkh9]

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

[okra85]

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 .

[okra85]

Am I right in thinking that some Dermatophytes are considred type of parasites and that would explian my high IgE levels?

[okra85]

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

[okra85]

Sorry, how about the vaginal infection? Can I use an antifungal cream for it too? Like Lamisil

[okra85]

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?

[mkh9]

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

[okra85]

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.

[mkh9]

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

[okra85]

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

[okra85]

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

[mkh9]

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

[okra85]

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

[mkh9]

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

[okra85]

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?

[mkh9]

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