Aspergillus with MAC

Posted by franthony @franthony, Feb 20, 2019

Has anyone else picked up aspergillus (pulmonary fungal infection) while being treated for MAC? MY ID doc has it on watch because it can't be treated while I am being treated for the MAC, due to drug interactions. It doesn't help that my local clinic threw out my last two culture specimens for fungus because there was not enough for AFB cultures even though I wrote on big Sharpie twice on the second one was for fungus. I also have colonized pseudomonas, and am not currently being treated for that.

If you do have this situation, how has your doc been handling it?

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@franthony yes I have had aspergillus show up along with my MAC and abscessus. dr said it was a small amount so we are just Continuing to surveill sputum samples. Th anks for your post, please let us kno your progress. Good luck to you!

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@franthony Wow! That is indeed a conundrum. I am hoping to interview my doctor soon about treatment plans. I will def ask him about this situation. I wonder if a bronchial wash would help with the fungals? Are you doing the nebulized saline?

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@windwalker

@franthony Wow! That is indeed a conundrum. I am hoping to interview my doctor soon about treatment plans. I will def ask him about this situation. I wonder if a bronchial wash would help with the fungals? Are you doing the nebulized saline?

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No, just the trifecta of antibiotics. the first sample of aspergillus said

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@franthony

No, just the trifecta of antibiotics. the first sample of aspergillus said

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@franthony Was that a no to nebulized saline (7% sodium chloride)? If so, you may want to talk to your doctor about prescribing it for you. You will need a script for the nebulizer also. By doing a twice daily cleanse with the saline, it will help to prevent things from taking up residence in your lungs.

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@windwalker

@franthony Was that a no to nebulized saline (7% sodium chloride)? If so, you may want to talk to your doctor about prescribing it for you. You will need a script for the nebulizer also. By doing a twice daily cleanse with the saline, it will help to prevent things from taking up residence in your lungs.

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Oops, yeah, that was a no. She's talked about it. I currently have an albuteral nebulizer that I don't use. I guess we will decide what to do at our March appt. Thanks.

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@franthony Why did your dr say no?

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@franthony To answer your original question about catching another type of infection while on antibiotics, yes, this happened to me. I had been on Ciprofloxacin and Doxycycline for three yrs to treat mac. I tested negative after the first six months, but stayed on the antibiotics to get it good and gone. Then, pseudomonas cropped up in 2016, and my Dr switched out the doxycycline for inhaled tobramycin. That drug cleared the pseudo out after 30 days. I was kept on the bi-monthly regimen of Toby and Cipro up to the present. I have tested negative for everything since 2016, but am kept on the meds as a preventative measure. My Dr says he is now treating the bronchiectasis, not infections. This treatment plan has worked for me. I feel fortunate that meds chase these bugs out fairly quickly, because for some, it is a long uphill battle.

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@windwalker

@franthony Why did your dr say no?

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She didn't say no. I didn't understand how it would be helpful, and with so much to discuss, I think it got left to the side.

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@windwalker

@franthony To answer your original question about catching another type of infection while on antibiotics, yes, this happened to me. I had been on Ciprofloxacin and Doxycycline for three yrs to treat mac. I tested negative after the first six months, but stayed on the antibiotics to get it good and gone. Then, pseudomonas cropped up in 2016, and my Dr switched out the doxycycline for inhaled tobramycin. That drug cleared the pseudo out after 30 days. I was kept on the bi-monthly regimen of Toby and Cipro up to the present. I have tested negative for everything since 2016, but am kept on the meds as a preventative measure. My Dr says he is now treating the bronchiectasis, not infections. This treatment plan has worked for me. I feel fortunate that meds chase these bugs out fairly quickly, because for some, it is a long uphill battle.

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@windwalker if you care to share, what is your lung function? Are you on O2?

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@brigby Hello. No, of course I don't mind sharing. My lung function is at 37 % as of my last Lung Function Test (LFT) last June. I am getting another one done in the next month as my shortness of breath has gotten worse. I have COPD, which is a progressive disease, so it could be that getting worse, or it might be that I have not been to the gym in three months. My severe lung disease is due in part also to something genetic of which they cannot figure out. My diaphragm is totally flat and stiff; so, it requires more effort and concentration to breathe normally. I am on oxygen at night because the conscious effort to breathe diminishes due to sleeping. My 02 levels drop to about 80 many times during the night for periods longer than 5 mins. I must use a portable 02 concentrator when I go to the gym. There is NO way I could exercise without it. This all sounds bad, and it is; but, to meet me, you'd never know it unless you were beside me after taking the stairs. That is when it becomes obvious.

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