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Fungal Infection Trust
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Need to have another opinion and evaluation in US

Hi Mr. Gatherton,

I find that the itraconazole is not really working any longer...don`t know why. I am on 300mg. a day and my levels were 1.7 at 400 so was reduced. My Pulmonologist is thinking that I should be treated for my NTM which I have done in the past successfully although you never get rid of that. He is unfamiliar with a lot of ABPA as he has very few patients with this. Bronchiectasis is is specialty and he has been excellent in keeping me going to bouts of infection etc. ...perhaps I should have had a CT scan more often or bronc. but now...for whatever reason ...I am getting sicker and sicker. The Itra. worked for a few months until I reduced to 200....now back up to 300...asthma is really horrible...I can't do anything and using steriods too much as well as rescue inhaler. I really need another evaluation and would like to know if you could recommend the best hospital in the USA for this...or if you ever do that. My Dr. would be fine with this I am certain as he is frustrated with my unresponsiveness to treatment and would work with them. I was first diagnosed with MAC and asthma at National Jewish in Colorado in 1996 and was on 3 series of meds. but have not taken MAC meds for NTM since 2007 or8. I need to know if the sudden (last 4 months) breathing difficulties is a progression of the disease, bronchiectasis, MAC ....ABPA or all of these. I do know that I need to get an answer asap as I can tell I am getting physically compromised at this point. Thank you for any answer you may have or a physician that would be familiar with this difficult combination of pulmonary conditions and treatment for same. I am willing to come to Manchester for an evaluation if that would be possible...of course, better here in states but I feel that I need to get a handle on this sooner than later. I am getting weak and the winter season hasn't even gotten here yet...due to bring some illness as usual. Thank you for your help. Hannah

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YouTube search Andrew Saul

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Hi Hannah

It is possible that your itraconazole is not working due to the infection becoming resistant, but it is also possible that NTM is flaring up. Treating both at the same time is problematic as the drugs interact, it looks like treating NTM might be the best option. You really need a specialist in infectious disease to give an opinion on what to do next.

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Hi Mr. Gatherton, Have just returned from a stay at hospital and was treated for Moraxella pneumonia...had IV antibiotics and am on oral now so I don't think it was an issue of the itraconazole not working or NTM action up after all. I do not have pseudomonas to battle as I thought but I am grateful to the group of Infectious disease drs. who tested everything and treated me for the Moraxella. Feeling much better now. I will keep in mind the difficulty of treating both NTM and ABPA as I start next week to see a pulmonologist from the group that treated me this week. I'm glad I decided to go to the ER when I did as I was getting quite sick. Much better now. Hannah

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