Primrose123: Has anyone been prescribed... - Lung Conditions C...

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Primrose123

primrose123 profile image
17 Replies

Has anyone been prescribed Incruse Ellipta 55mg for lung fungus? If they have, how did they find it? All answers gratefully received!!! Thank You..x

17 Replies
Damon1864 profile image
Damon1864Volunteer

Hi primrose I've no Idea how they found it but at least you are getting treated for it. Have a good night and take care 😊 Bernadette and Jack 🐕 xxxxxx 🌹

primrose123 profile image
primrose123 in reply to Damon1864

Thank you Bernadette & Jack for your kind reply, I think possibly it was the blood tests, but I am not quite sure, just wondering. if anyone else has been on this medication, & if so was it beneficial to them..Hope all good 👍& well with you both!!Take care,& God bless..x Primrose123..

Charlie_G profile image
Charlie_G

Have you had fungus confirmed by sputum, and if so, is that the only treatment you’ve been given? Incruse is purely a bronchodilator, albeit long acting, so it won’t treat any bacteria or fungus causing a problem. Persistent wheeze in particular is a common symptom of fungal infection, along with increased breathlessness, so it might potentially help reduce those a bit if you’re finding them an issue, but like with a bacteria, the fungus itself needs to be treated. Our experience of inhalers being given when fungus was the issue was that they did nothing to help because they didn’t address the underlying problem. Even with ABPA, which is an allergic type reaction to contact with airborne spores of a specific fungus, my understanding is that you still have to treat that with steroids as a minimum.

slram profile image
slram in reply to Charlie_G

How do you even get a lung fungus? Thanks...

Ergendl profile image
Ergendl in reply to slram

Minute spores float in the air, so we breathe them in. If there are enough of them and they find a moist place to live, like lungs with lots of mucus and not many beneficial bacteria or a healthy immune system to stop them, they make the place their home and reproduce.

slram profile image
slram in reply to Ergendl

Thanks so much! I am learning more here than from my doctor!

Charlie_G profile image
Charlie_G in reply to slram

They’re environmental infections, so arising from the natural environment around us, like in soil and still or stagnant water. Generally speaking, only those with an underlying lung disease or that are significantly immunocompromised somehow get environmental infections, as a healthy lung is inhospitable and the fungus (and bacteria) can’t multiply. As Ergendl says, the spores in the air are inhaled - it’s no different to how people that are susceptible catch bacteria like pseudomonas (and they often inhabit the same or similar places). In cf, which is a condition where people are very prone to catching these kinds of pathogens, people are advised to actively avoid activities where we know the likelihood of encountering certain bacteria and fungus are high, like using compost, or being around an area where it’s being spread/used: the key issue with any of these things is that disturbing the fungus is the primary risk factor, rather than them simply being present. Black mould like the kind you might find on a damp internal wall is the most common fungus to cause issues - it’s called aspergillus - but cleaning it up is far more risky than it being left alone. Certainly in cf, the guidance is that the person with cf has to be out of the house during any cleaning of it and for at least 48 hours afterwards to allow the spores to dissipate. With aspergillus specifically, you can have an active infection where they’re multiplying in the lung, or you can have an allergic type reaction known as ABPA where the spores cause an allergic irritation to the airways, leading to wheeze and other symptoms, or if you’re really unlucky a mix of both, but we now know there are multiple fungi that can cause issues, and a spectrum of disease. Although we’ve been aware of it for years, fungal infection is an area we’re only really just starting to get to grips with and properly understand now.

Edited to add: worth pointing out that larger volumes of black mould can also cause symptoms of irritation in people without underlying lung disease, which is why some people become unwell with respiratory symptoms if living in a home with a mould and damp problem..

slram profile image
slram in reply to Charlie_G

Thank you so much for the wealth of information. As my pneumonia was viral, I tried to find answers on the net to avoid another bout of it. Your reply was a great help!

slram profile image
slram in reply to Charlie_G

You are obviously intelligent so if I may, I'd like your insight on what I am dealing with. You replied to my quetion about viral pneumonia recently. I had bacterial pneumonia about four years ago and it took me about four months to get over it. While sick, I was losing my hair and when I recovered, all was well. Hold that thought. I quit smoking in '03, no issues with COPD or anything else. I was diagnosed four months ago with the viral and the hair issue started again. I am just beginning to feel 100%; I was functional but you know the story. The hair thing started again but is continuing. You can't tell by looking, but I have brushfuls of hair that would normally take a week to get. (I clean it daily, but I know.) I am building my strength back up with weights and yoga and youtube dance videos. This bout took every bit of strength I had and I was shocked. I am still not right but I am getting there but the hair issue has me concerned. Thanks for listening and if you have any thoughts, I'd appreciate them.

slram profile image
slram in reply to Charlie_G

(Not to mention this cough)

primrose123 profile image
primrose123 in reply to Charlie_G

Many thanks Charlie_G for your kind & most informative reply, I have had several blood tests, but I have not had a Sputum Test, I was diagnosed with asthma around 10 years ago & bronchiectasis about 6 years ago, I have been prescribed many courses of prednisolone & antibiotics, ( amoxicillin)every 6/8 weeks within the past few years, due to recurring breathlessness, but recently have been on doxycycline which I found to be much better, but however I had asked for a 2nd opinion & the consultant I have been attending has given me blood tests & told me that I have chest & lung fungus, & has prescribed Itraconazole 100 mg capsules,(1 to be taken twice per day) & also the Incruse Ellipta inhaler..I wondered why I was prescribed an inhaler as I am already on a strong inhaler( 4 puffs per day) & this was to be added to my daily dose..I hope all good & well with you Charlie_G, & Thanks again for your sound advice, it has been very much appreciated ..Take care,& God bless.. Primrose123..x

Charlie_G profile image
Charlie_G in reply to primrose123

So the blood tests would have been your aspergillus specific IgE and IgG. Very elevated IgE (usually considered to be levels above 500) is consistent with aspergillus infection and/or ABPA, so is considered fairly definitive even without a positive sputum. Itraconazole is an antifungal, so should hopefully sort you out if you’re given a sufficient course, although IV antifungals can be necessary if fungal infections have been left untreated for a while and have taken root. I’d imagine the Incruse likely is to try and aid the symptomatic breathlessness in the meantime.

As you have bronchiectasis, it does sound to me like you’re potentially not receiving an appropriate standard of care. Certainly not from the first consultant at least. My understanding is that monitoring IgE is something that should be fairly routinely done in bronchiectasis, and certainly in someone that’s experiencing increased symptoms that aren’t resolving, exactly because we know it can be a problem. I hope this second doc is more on their game and sorts you out.

primrose123 profile image
primrose123 in reply to Charlie_G

Thank you again Charlie_G, I am extremely grateful for all the 1st class information you have given me regarding my medical conditions & all medications that I have been prescribed, you are most emphatically extremely knowledgeable in many aspects of the medical field, by explaining so much to me in detail regarding my own medical health & medication,I now see everything & understand all in a totally different light..You have been a real Godsend to me Charlie_G,& I am totally delighted that all went well with you too... I wish you good health & much happiness for the future..Take care, & may God bless you always Primrose123..xx

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primrose123 profile image
primrose123 in reply to Charlie_G

Charie_G, my family ,friends

primrose123 profile image
primrose123 in reply to Charlie_G

Hi Charlie_G, my family & friends were remarkably impressed by the abundance of 1st class knowledge that you have given me..My elderly neighbour has asked me to ask you if you would be kind enough to give her a little advice too regarding a a recurring on/ off wheeze & cough which comes & goes maybe every 4/6 weeks, she has had a chest xray + a CT scan which she was advised that both came back clear, doctor told her it was probably her age & did not prescribe any medication.. She has high blood pressure, but in general keeps good health, but this wheeze/ cough does get her down, she has asked me to say that she would be most grateful if you could please advise her on this problem Charlie_G..Thank you...x

Lutontown profile image
Lutontown

I've told this tale a number of times on this forum. In 2016 I had loads of chest infections, so in 2017 I kept a diary and counted 18 chest infections in that year. In March 2018 we had our bath replaced by a walk in shower, and when the bath was removed the floor of the bathroom was found to be covered in Black Mould. Duly, the floor was totally replaced eradicating Black Mould, and since then I have had no chest infections. Since then, only two courses of antibiotics for Sinusitis, but did have a spell in Hospital with Pneumonia and Pleurisy, when I had to have loads of antibiotics. Black Mould forms in damp dark areas, so worth hunting round for it; anywhere where there could be a water leak.I noticed that Charlie_G mentioned black mould as well.

primrose123 profile image
primrose123 in reply to Lutontown

Thank you so much Lutontown for your most helpful & interesting reply.it has all been much appreciated..Hope all good & well with you now...Take care & God bless..Primrose123..x