Bronchectasis question : Hi all I... - British Lung Foun...

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Bronchectasis question

Carkaisabellacolin
Carkaisabellacolin

Hi all

I wanted to ask 2 questions. Does anyone suffer with repeated candida infections in the lungs. And has it effected your breathing. Also does anyone have good oxygen readings but still feel like they dont have enough.

I feel a bit confused as my readings show high but with activities i keep getting dizzy spells and gasping for breath.

Are these things commom for bronchectasis patients.

🤔Simone

22 Replies
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hi, many moons ago before late onset asthma and beginning of lung ill health was diagnosed with candida in the gut. Had to go on a completely sugarfree regime for months before it cleared. Was told sugar feeds candida so must starve it. I have absolutely no idea if that would work for lungs though. Are they sure its candida? Aspergillus commonly inhabits the lungs and antifungals are prescribed for it . P

Hi

Yes they are sure its candida i am waiting for my microbiology tests . But my sputum samples keep showing it and recent bronchoscopy detected it again.

I am taking an antibiotic. And antifungal treatment. Prescribed for 3 weeks.

If you cut out every form of sugar that may help too.

Thanks i think i will try this.

I need to try something😊

I have it in my lungs, detected in last 3 specimens but no advice or treatment given! Ive severe bronchiectasis, throughout both lungs.yes to most of yr questions but not dizziness with exercise as cant do much.pulmonary rehab taught me to move goalposts- slow down, learn breathing techiques.it was a gamechanger 4 me & think u would benefit from ths advice

Charlie_G
Charlie_G in reply to Patk1

They won’t be treating it because, with one or two notable exceptions, candida species are not generally seen as needing treatment. They only very rarely cause infections in respiratory disease, more usually it’s a colonisation within the airways that’s just there - they’ve moved in but don’t actually attack. It seems to most frequently occur in patients with chronic bacterial infections involving things like pseudomonas and staph aureus. Whilst not completely understood, the current belief is that it’s not pathogenic in the majority of respiratory cases, and therefore they leave it be unless they have reason to suspect it is actually an active infection causing harm. About 30% of cf patients routinely grow various Candida species, and it’s known to be a common finding in all productive respiratory diseases including NCFBE and COPD.

I think they decided to start treatment because it keeps showing up and also i have been very unwell. Very bruised sides extremely painful all day unable to sleep . A cough and phlegm sticky . Have been on nebulised meds for 3 months but still feeling more tired.

So i think this could be what has not been helping me. I know that they say its common and often needs nothing but i do think listening to you and the recent Dr wanting to really try and treat it seems he suspects that its trouble.

Thanks i will slow down .

I am like you both lungs badly damaged and looks like breathing techniques would help aswell. But i have started treament 😊

I have just got over an exacerbation followed by thrush and was suffering with quite bad breathlessness once I had had the fungal medicine it gradually went. I knew I didn’t have thrush in the the mouth but maybe it was the throat. The breathless went but it did worry me a lot. My o2 reading vary a lot they usually go between 88-93. I have bronchiectasis with pseudomonas and severe asthma.

Sounds a lot like me. I do have asthma as well . Last time i had in my throat also had pseudomanas had treatment for over 4 months.

Hopefully it sounds that with the fungal treatment things should start start to get better.

Thank you so much for replying 😊

To be honest I have learnt so much from being on here when someone has similar or the same symptoms it makes sense why you are feeling that way. I couldn't understand why I was still breathless after the infection and it seemed worse than normal but my sputum test showed the thrush was given medicine and after the course felt much better. Wishing you better soon. X

Thank you 😊

How long did you have treatment for?

Only 7 days but after I finished the course I noticed my breathing was getting better my 02 levels increased slowly. X

Candida is a ‘funny’ one. True, invasive lung infection by Candida species is rare, mostly occurring in the immunocompromised and usually making people really quite unwell, but it’s known to be a frequent coloniser of the upper airways in all productive respiratory conditions, with about 30% of cf patients (the group I’m familiar with) regularly testing positive for it via sputum. My daughter had cultured c.albicans in almost every sputum sample for 2 years prior to moving teams last year. She was really ill when we moved and had been for a while, no one was sure what we were dealing with, but we did have yet another Candida growth, and it was the only thing we knew about that we hadn’t treated to see if it helped. They gave her 3 weeks of fluconazole whilst in hospital for a month, which is usually the drug of first choice, and although we didn’t see the Candida again for a number of months, we subsequently found the issue was actually a fungus (possibly 2) we’re still dealing with now, so the Candida in her case is almost certainly a colonisation issue rather than an infection. The albicans has been back in samples a couple of times this year, and she fairly recently also started culturing another Candida (c.dubliensis): there are a couple of retrospective papers looking at the relevance of both albicans and dubliensis in relation to lung disease and decline in fev1. The consensus seems to be that you often find Candida species in patients with chronic pseudomonas, and multiple strains in one patient may be indicative of a more severe lung disease profile. That would certainly hold true in my daughter’s case, but the reality is we just don’t understand the relevance or importance of Candida species in relation to respiratory disease at this point, or the various relationships between different pathogens within the lungs and airway more generally.

As for the breathlessness, I’m wondering if what you’re experiencing could potentially be dysfunctional breathing rather than exercise driven SOB. I’ve mentioned this before in posts, but my daughter would frequently complain of inexplicable breathlessness even when she was otherwise relatively well, but it could be quite intermittent, sometimes varying within the same day. She did have a fairly consistent lack of exercise tolerance, though, that was identified by physios when we moved, so they did a CPET (cardiopulmonary exercise test) and we discovered that her sats were occasionally dropping below 90 during activity entirely as a result of the way she was breathing. Long story short, although it wasn’t apparent from watching her, where she’s had several prolonged spells of poor chest health over the last 3 years she’d fallen into a pattern of accessory breathing. You usually only accessory breathe either when you physically have to due to a bad chest infection, or as part of the fight or flight response, but it’s a vicious circle. You start to accessory breathe, which releases more adrenaline and cortisol etc., the stress hormones, which makes you more anxious and stressed, which makes you more breathless, which makes you accessory breathe more. It turned out my daughter consistently did this during exercise, explaining the exercise tolerance and SOB issues, but the link with anxiety/fight or flight also explained why some days she could do an exercise class without much difficulty but the next barely be able to manage 200m around Tesco. She has high baseline levels of anxiety as the result of being on the autistic spectrum, so her accessory breathing was also found to be linked to her anxiety levels in any given situation.

Thank you

Having read this, this morning it makes a lot sense. It hss been showing up for years and the pain now that o think about eases of with the treatment but comes back not long once i have stopped it meaning its not really cleared.

I will defiantly speak to my consultant this week. As they need to help me clear this pesty thing.

Your message has really helped

X x

Glad it helped, but just bear in mind that with colonisation, there is no getting rid of it, and most medics won’t treat it - it’s not an infection that can be treated, it’s just there in the airway. It’s actually really difficult to definitively establish if you have a Candida lung infection, but if it is actively and repeatedly making you unwell by itself i.e. there are no other bacteria or pathogens active at the same time to explain why you feel unwell, that makes it a chronic infective problem rather than colonisation, and then I would be asking about the treatment you’re being given for it. Fluconazole is usually first choice, but my understanding is that there are other azoles that are stronger and sometimes effective depending on the Candida in question. That said, we now routinely give strong IV antifungals (amphotericin) with every course of IV antibiotics the child has, and we also use posaconazole in the same way that you use oral antibiotics at home to try and suppress the other fungi we’re dealing with, but her particular Candida colonies just keep on keeping on 🤷‍♂️

I started treatment friday after the bronchoscopy.

Syprup to drink 5 times a day antibiotic syprup as oral dosage reacts terribly in my system plus probiotics and something for my stomach.

Failing this they said i would have to have other meds but mot mentioned what.

I am also on nebulised antibiotics for an infection in my lungs.

I will speak to them regarding the Candida if it is colonized or not its all new to me . Learning.

Thanks again

I have repeated Candida infections of the throat & if I don’t catch it in time my fev1 readings go down a bit. I don’t think I get it in the lungs, but I do think I get it in my stomach as indigestion is one of my late warning symptoms.

Mine has been throat ,lungs and stomach .

In all my analysis it has shown up for years . At the beginning it wasl left untreated as seen as not a problem.

But now its constant showing in sputum tests and recently on my bronchoscopy

How long do you have treatment for?

I used to buy a fluconazole tablet & take when I needed it. Then my GP told me I shouldn’t be taking fluconazole & azithromycin as both affect the liver & you can’t buy fluconazole over the counter if you are over 60 (which I now am). So I now have a week’s worth of Nystatin.

You’re right that no one sees it as a problem which is frustrating.

Interestingly, my inhaler was changed from Seretide to Fostair but, as I didn’t get on with it, it was changed back, but on Fostair I noticed I got Candida less!!

I am starting to realise that we have to become drs ourselves to manage these correctly in order to have better quality of life😉

Yes,we do.i decide when to start steroids, and v often change antibiotic - practise nurse usually asks what a/b shall we try.so my guess is as gd as hers ))

My gps are v gd though.but,theyre no hep with steroid induced anxiety.they sent me a cpl of links!! I wazs on them for 3months continuosly earlier in year.so anxiety etc was v tough.

I do hope everyone gets flu jab soon,to help protect us xxx

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