Systemic Fungal Infection: Can it cause thyroiditis and how best to treat?

Posted by krinzgal @krinzgal, Jul 17, 2011

Has anyone had experience with systemic fungal infection in a child with a normally functioning immune system? My daughter has a host of problems, including chronic sphenoid sinus disease with recurring polyp.

She just had her second sinus surgery. In the month prior to the surgery she had a urinary tract infection with positive urine cultures for Klebsiella pnuemoniae. Her only symptoms were feeling achy and having right flank pain. They put her on Macrobid. That didn’t resolve her symptoms of right flank pain and she still felt achy, so they put her on a round of Septra.

She saw an ENT at that point because she has chronic sinusitis and thick nasal mucus with cough. A CT showed showed significant ethmoid sinus infection and a sphenoid nasal polyp–the same symptoms she had prior to her first surgery a few years ago.

Because of a similar history with her brother and because he presented with the unusal symptom of oral thrush a year before, a doctor told me to be sure that if she be checked for fungal infection. I asked the ENT to culture for fungus when he submitted her tissue for culture following this recent surgery.

Her cultures were negative for bacteria, but positive for Candida albicans, a fungus/yeast.

From what I have read and from what a general practitioner advises, she could have a systemic fungal infection. He put her on Diflucan four days ago. Now she is having the symptoms of “die off.” Fever, sweating, feeling flu-like.

I’m cautiously optimistic that we may have figured out what has eluded us for years as an explanation of her various symptoms.

Has anyone here experienced a systemic fungal infection that was effectively treated? She is not immunocompromised. She does have multiple antibodies of type 1 diabetes and has autoantibodies for thyroid peroxidase and thyroglobulin. But from what two rheumatologists have told us, her immune system is working perfectly fine.

She has thyroiditis shown on PET scan. Is it possible her body is attacking various tissues because of fungal infection? If this is a systemic problem, can anyone recommend a doctor to see? The ENT is referring us to an infectious disease specialist locally, but if anyone knows of someone particularly qualified to handle this condition, I would love to have those recommendations.

Thanks for any input.

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How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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The ENT did not want to culture the tissues initially, but I asked again and he said he would do it. He said because of her unusual history, it warranted checking.

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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I was told that they don’t do cultures anymore. It seems to me that is the only way to find out what the culprit is without trying a slew of unnecessary antibiotics. When you say your daughter is not immunocomprimised, what do you mean by that? Did they initially suspect allergies? Does she have or did she have nasal sinuitis (runny nose not related to allergies which I guess would be immuno-deficient). Did you have a hard time with Doctors diagnosing symptoms rather than origination of the problem? How did you get insurance coverage at Mayo Clinic, because of GP referral? I hope your daughter is better. Sinus and ear problems are horrible and debilitating.

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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Also, I wanted a fungicide and was told we need some yeast in our bodies, so no fungicide. I have itchy pain stabs in my ears and bloated stomach, feel full quickly. It sounds like your daughter is worse than I am but when I actually had sinus infection and bronchitis it was just horrible. How long did her flu last after the fungicide?

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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She was better two days after taking the last Diflucan tab, as far as the flu-like symptoms. We finally have an appointment with a thyroid specialist who handles difficult endocrine cases. The reason he agreed to see her is because of her elevated antithyroglobulin and peroxidase autoantibodies. We see him September 21. I will be asking him about the possible role of fungal infections.

As far as our bodies needing yeast, that’s true just like our bodies need beneficial bacteria, like those in the gut that help us digest food properly. What apparently has happened for some people is that overuse of antibiotics allowed fungi like Candida albicans to get a foothold and resulted in an overgrowth. You don’t want to eradicate it, but you do want a balance, just like you need a balance of “good” bacteria.

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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How can you determine when you have balance? Is there a test?

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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I know this is late, I just signed up. I was diagnosed with fungal infection in my throat in 2009 at Mayo Clinic. I am still having extremely bad pain in my jaw, neck, and pharyngeal areas, have been treated numerous times with Diflucan but am questioning if they ever gave me enough. Do you remember the dosage they gave your daughter? I have seen so many doctors and had so many tests I’m at my wits end. Had my tonsils out in May 2012 and forgot to specifically ask the doctor to send them to pathology so never got a culture from those. Thank you!

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Good grief. I don’t know if your daughter is really sick or if this is a hobby for you to read up on symptoms, and diagnose her, like med students sometimes do. I would just take her to Mayo Clinic and let the Docs diagnose her. UPYou are a mom, not her full time Dr . Not being rude, but I am concerned that you are trying to one up the Docs.

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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It comes in sigle dose packs. They prescribed two, taken 3days apart. She recently had yeast in her urine. I believe she has a chronic infection. So, we have not successfully eradicated it. Have you had an evaluation by a thyroid specialist? My daughter has Hashimoto’s. Since being on Synthroid, her TSH actually went up. Her endo says that is expected from a thyroid that has been forced into dormancy due to the autoimmune attack. She has had the same pain you describe. I encourage you to seek an evaluation from a thyroidologist. Hope this helps and good luck!

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It’s important to keep adding probiotics to her system. I ferment cabbage in water for a few days — about 1/8 of a head of cabbage in the blender with filtered water enough to fill two canning jars. This gets put on top of my water heater where it will stay nice and warm. When it’s fermented then I strain the cabbage and drink the juice. It smells terrible, but it tastes good. And it really helps! It’s chock full of probiotics and it’s less expensive than the alternatives. Plus — it’s such a strange thing to do that it’s a great conversation starter. 🙂

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@jaanderson1

Good grief. I don’t know if your daughter is really sick or if this is a hobby for you to read up on symptoms, and diagnose her, like med students sometimes do. I would just take her to Mayo Clinic and let the Docs diagnose her. UPYou are a mom, not her full time Dr . Not being rude, but I am concerned that you are trying to one up the Docs.

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We have been to Mayo Clinic in Rochester twice and had very thorough evaluations from multiple specialists there. We followed up with our local physicians as they recommended. Hers has been an extraordinarily challenging case, and obviously the chances of elucidating the cause of all her health issues could not possibly be accomplished with just two visits. Cost, inconvenience and her inability to comfortably travel prevented us from returning to Mayo Clinic. Her doctors there were always willing to help. Getting local doctors to work with them proved to be a major challenge.

We live over a thousand miles away. We had to continue with evaluations at home. Mayo Clinic provided very detailed recommendations on how to pursue management of her symptoms when we returned home. That was three years ago.

She is experiencing a dramatic resolution of her issues with muscle fatigue after taking Synthroid properly and at an appropriate dose. Her TSH continues to be high, but we now are receiving very effective treatment from a board certified endocrinologist here. We are like a lot of families who visit Mayo Clinic to hopefully get pointed in the right direction and continue care at home.

Your post echoes one of the greatest difficulties patients like my daughter face. It is assumed that if doctors can’t figure something out with a few visits, the best course of action is to accept that and do the best you can with what you have. That has never been acceptable to my daughter. She has always felt that if she persevered, someone would put at least some of the pieces together so that she could enjoy a better quality of life.

We have see some of the very best physicians in this country. Some of those are at Mayo. A majority of them agree this has been a confounding case. As her mom, if I had simply done what her first doctor advised, I know that we would simply be watching my daughter slowly deteriorate. LIke so many parents of children with undiagnosed conditions, I had to take on the role as her primary advocate because doctors do not have the time to document symptoms, medications, test results and research the possible causes of a plethora of health issues. I have always appreciated the ones who will openly acknowledge their limitations.

No, I am not interested in “one upping” any doctors. All I have ever wanted is for someone to figure out at least some of the answers that could provide her a better quality of life. She enrolled in college today, something that just a few months ago would have seemed an impossibility. Her endocrinologist used the information we have collected over the last ten years to determine what has turned out to be a very effective and promising treatment.

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@kimlee

How did you get your doctor to culture her tissues, none of the doctors I went to will do it. They are guessing for my cure!

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I was exposed to some bad fungi while I taught school and since then I have had numerous urinary tract infections and now I’m dealing with fibromyalgia. I don’t know which doctor to see to find cause of my UTIs. Any suggestions would be appreciated.

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