Update on pseudomonas

[Warrior4104]

Hello all. In my last post I had told y’all about a low grade fever after 20 days of treating pseudomonas as I have bronchiectasis and my doc ordered a sputum culture which felt like pseudomonas to me but it was not. In fact, there was no pseudomonas on the culture this time. Which means that I am Pseudomonas Free, or maybe a low number that didnt show up. Anyways, a new problem that I got in is Aspergillus Niger and Rhizopus species. I have no idea what these are. My doc said these were a type of fungus that are present in our normal flora, the reason that levofloxacin didnt work for me. He prescribed sporanox 200mg/day for two weeks. Does this mean I have ABPA?

Lastly I want to thank the whole community for their support. You guys are a relief. I am such a hypochondriac that I start to panic. If I hadn’t joined y’all I would be very stressed. Thank you so much. Keep supporting us.

[Hidden]

Yes aspergillus can throw a nasty extra into the mix with bronchiectasis. It is a fungus which is present everywhere and can get into the lungs of those who have damaged ones. It can be dealt with using the right antifungal drugs. Your doc seems as though they are on top of it all. With bronch it is a case of 'suck it and see' and constantly keeping on top of the little bug devils. It's good news that the pseudomonas is down to such low levels that it isn't showing up. I hope that you are soon back on to an even keel and able to crack on with life again. As soon as problems arise get on to your doc. When we are poorly with our bronch it can be very scary, frustrating and debilitating. With a good specialist we can feel safer that they will look for the cause of the present problem and get us on our feet. We are here for you. X

[Warrior4104 in reply to Hidden]

Yes. I trust my doc. But, is this aspergillus treatable? Or will it keep returning? I am taking itraconazole.

I bother you alot. You are really experienced and I love taking advices from people who have gone through something similar. Thankyouuu Littlepom

[Hidden in reply to Warrior4104]

it is no bother at all. I have been lucky enough to avoid getting aspergilla in my lungs although my blood tests occasionally show that I am reacting to it. Itraconozole is well known anti fungal drug. I don't know enough about aspergilla to advise you on its treatment. It would be a good idea to quiz your doc about it. There are several members of the forum who have problems with aspergilla. Hopefully they will be able to tell you if it needs ongoing treatment or can be dealt with in one course.

[Warrior4104 in reply to Hidden]

Thanks for your kind words. Best wishes for your health.

[Hidden in reply to Warrior4104]

thank you. We keep on keeping on and help each other along when the path gets rocky.

[eleanordigby]

I have ABPA caused by aspergillus fumigatus, it comes & goes. I take itraconazole (sporanox) when needed. It can make me very breathless but itraconazole helps a lot. It takes six or eight weeks to work so I usually take it for six months. Maybe your species is different. If it becomes a big problem you should see a doctor who specialises in it. It can make some people very sick but after over 10 years I’m still ok, it’s just annoying. Also there are other drugs you could try, and you can have a higher dose into your veins. So don’t worry

[Warrior4104 in reply to eleanordigby]

Thanks for letting me know. Yes I have a different species Aspergillus niger. I didnt discuss with my doc more about ABPA and all but I will surely.

[Lapis5 in reply to Warrior4104]

Itraconazole did not work for me. My Infectious disease dr put me on Vorzonazole, which is stronger .. may have to take it for months. I have Aspergillus, Pseudomonas colon ized, Hayline mould and now Candida from nebulized Colistin .,

Psedomonas wil lhave to be treated again soon I now have. PORT after going thru 4 round of a Pic w antibiotics in vein. So hopefully it will be easier to do at home.

Bronchiectasis now for 4-5 yrs..

[Alberta56]

These lung bugs are nasty little blighters. They get into our lungs and are reluctant to move out. They can be shifted though. Good luck in getting rid of yours ASAP.

[slram]

Is that viral pneumonia? You have different terms over there! Thanks....

[Hidden in reply to slram]

No. Not sure which bit you’re querying, but with the caveat that I’m not medically qualified, will break down the terms the OP used. Pseudomonas is a family of environmental bacteria that can cause infections in people with certain respiratory conditions, including bronchiectasis. The main pseudo that causes problems is pseudomonas aeruginosa, which can be difficult to treat, and as a result can ultimately turn into a chronic infection whereby it’s permanently present and has to be managed with daily nebulised antibiotics to try and keep numbers down. Aspergillus is similar, but a family of fungus rather than a bacteria. The main problematic one is a. fumigata, but there are a couple of others that show up including niger. In addition, some species of aspergillus can cause an allergic response in some susceptible individuals, which results in a condition called allergic bronchopulmonary aspergillosis, or ABPA. ABPA is managed with antifungals and oral steroids, but tends to cause pronounced breathlessness and wheeze. Hope that helps.

[slram in reply to Hidden]

Very much! Thank you!

[Warrior4104 in reply to slram]

Exceiiently explained by Charlie G. If you have any other questions please do let me know. Best wishes

[rossiedavid]

Hi

Having read your post,I expect others have quite often said that sputum samples do not always show infection.

My daughter was ill last autumn with a similar problem… she also has bronchiectasis.. they thought she had some fungal infection, but it turned out to be nocardia which is quite a serious condition, but she had nocardia ,caught Covid in hospital,but came through after a few weeks on IV meds… she’s also had a kidney transplant,..just to say the nocardia presents sometimes as a fungal infection and it needs different medication.

My daughter has just had her second kidney transplant after 20 years, of the first one ,and a she’s doing well .

[Izb1 in reply to rossiedavid]

Sounds like your daughter has had a tough time rossiedavid and glad to hear she is recovering well after her second transplant, sending healing vibes x

[Warrior4104 in reply to rossiedavid]

I wish your daughter a good health. She has gone through a lot. These tough times can be understood by the loved ones and the experiencing person themselves. I hope that she gets better soon.

[Hidden]

With the caveat that I’m not medically qualified. No, the presence of aspergillus does not automatically mean you have ABPA. We’re only just beginning to properly understand the full spectrum of fungal lung disease, but ABPA is an allergic reaction to the presence of aspergillus fungus, and doesn’t occur in everyone that’s infected. Aside from symptoms, which in terms of persistent wheeze and breathlessness are usually quite pronounced, the main diagnostic gauge of whether someone has ABPA in addition to an aspergillus infection is a blood test called aspergillus specific IgE. My understanding is that in patients with bronchiectasis, both IgE and IgG should be routinely monitored: raised IgG indicates someone has been exposed to aspergillus in recent history, significantly raised IgE indicates current infection, typically presenting with ABPA. It used to be believed otherwise, but we now know it’s entirely possible to have a normal IgE but still have an aspergillus infection requiring treatment: in the presence of symptoms, normal IgE but raised IgG represents a person having fungal bronchitis. However, IgG elevations without any symptoms may just represent past exposure to the fungus.

[Warrior4104 in reply to Hidden]

Excellently explained. Thank you very much. I got my doubts cleared here. Well, the symptoms of wheezing and breathlessness cant solely indicate ABPA in me as I have asthma too and often these symptoms occur in me. My doc didnt order an IgG or IgE. I will definitely ask them about it on my next visit. Thanks again.

[Izb1]

So pleased to hear you have a good doctor and that you are pseudomonas free, keep well and take care x

[Warrior4104 in reply to Izb1]

Thanks. Best wishes to you too.

[JJ_7]

Hi. If you have not already found information on A.Niger and Rhizopus, I think you will find the following links helpful. There is also a case study:

ncbi.nlm.nih.gov/pmc/articl...

en.wikipedia.org/wiki/Asper...

en.wikipedia.org/wiki/Rhizopus

I won't offer advice, since the complexity of prognosis contains too many variables, and it is beyond my understanding of microbiology. Certainly takes me back to undergrad days though! I hope you are feeling better soon and look forward to hearing more from you. Get well soon xxxxx

[Warrior4104 in reply to JJ_7]

Thanks for attaching these links. I didnt scroll google about rhizopus, as it made me breathless when I read about A.niger. Google sir says that people with aspergillus niger die in 5 days. The inner hypochondriac of me woke up. I just didnt search anything more.

I am sorry for complex post😂 as a physical therapy student I didnt realise i have used many medical terms. My only question is, is this treatable? Nothing else. I was a hell scared from pseudomonas.

Thanks for your help and Best wishes.

[JJ_7]

Yes its treatable. Best wishes JJ_7 xxx