Fungus. Can this spread? Has anyone had this problem?

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Fungus. Can this spread? Has anyone had this problem?

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Oh...this is so hard to ask about. My 94 year old mother has had a fungus infection on her bum for a long time. Months it seems. I was there when they were treating it and the doctor told me it was improving....however two weeks later they just called and said it is bad. They say she is not allowing them to address it all the time and refuses treatment. Dementia, 94 and stubborn.

Anyone have this problem? Changed the diapers to what the doctor says she uses on her Mom but no good. Can this spread to her other parts of her body? Any insights?

Thank you all.
Marie

Alzheimer's & Dementia Mom Senior Health

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It's most likely candida. Bottom line is she isn't being kept dry, but if she is resistant to care that's going to be difficult.

https://www.healthline.com/health/adult-diaper-rash

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Thank you!

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Fungal infections are a beast as they are persistent. It’s hard enough doing successful treatment with a cooperative family member. Add a patient with dementia and it’s really hard to consistently treat the area and keep it dry or let it air.

if They haven’t run a culture on it yet, it needs to be done. There’s a lot of fungus….. and some are resistant to some medications.

There are a newer line of medications for fungal and bacterial infections that ime seem to work where all other have failed. But $$$. Specifically Crown Lab’s Ala-Quin, hydrocortisone .5% Iodochlorhydroxyquin 3%. It’s a cream, runs abt $450-$600 for 80 gram tube. Most pharmacy plans won’t cover it at all even with 80% copay as there’s a ton of other fungal meds available & all that have to be tried first. No generic. If you have a friendly dermatologist ask for a couple of sample tubes & see if the medical director will let the samples be tried on her. It’s amazing stuff. The hydro is a steroid so it deals with lessening the itching and redness and the iodo is a targeted antibiotic.

Make sure it’s ALA-Quin (Crown Laboratories) NDC 0316-0123-80.

Not ALO-Quin or Alcortin A, these are even more $$$$$ specialty Derm drugs. I’ve seen these 2 priced at $ 9,000 per tube. Crazy.

if the culture should show its tinea, theres a newer drug for it too. Luzu, Luliconazole cream 1%, Valeant Laboratories. It’s been out for a while so it has a generic that runs abt $100 & the regular runs $250/300.

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This is great info. Thank you

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They should reculture this. Fungal infections treated with the proper medication will clear, but often the absence of the fungal problem can open to infection with bacteria. Given that there is fecal contamination and the area is often not "open to the air" it is difficult to heal. Just talked about this on another question earlier. It can be a merry go round of fungal infection, bacterial, fungal, bacterial, and without wound culturing it is difficult to tell what is going on. This can come down to good wound care treatment and followup. It can leave someone looking like a piece of raw meat and be severely painful. I am sorry and wish you good luck.

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They have been treating it and it was getting better two weeks ago but now it is really kind of bad. Thank you!

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Murphy there are systemic treatments (i.e. tablets rather than creams or ointments) for fungal infections too, but it may be that your mother isn't well enough for these to be justifiable (they can be rough on kidneys and liver, from memory). Still, it can't hurt to ask her doctor, can it?

Fungal infections like damp warm places. Very difficult to avoid those in a person who is incontinent and wears protection.

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Pills? That would be easier for sure. Thank you

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Her problems has multiple causes:
1 - warm, moist, dark environment encourages growth of yeast and fungus
2 - her immune system is probably not in great shape
3 - she won't let others clean her often enough

Things that can help:
1 - Let her sleep without a diaper (absorbent pad underneath and on top) so her skin can dry out a bit
2 - Nystatin powder or cream applied to the rash with every diaper change and bath
3 - Anti-fungal oral medication
4 - if able, install a bidet attachment to her toilet so she gets "cleaned" every time she uses the bathroom
5 - Try to eliminate sugar and refined carbohydrates from her diet that may be "feeding the fungus"

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I 100% agree with everything you have said and listed. This method is 10x quicker and that means less suffering. Often times, I let the nurses in a hospital or rehab do what they had been trained to do, believing it works. (Pleading for the ‘ let it air out method ‘ never works, they insist on what they were taught) Respectfully, I bite my lip and wait..Always, after several days of them keeping the area gooped up with creams and keeping the area covered, damp and warm to grow worse. Even a few hours of drying out will help tremendously. The 2 things that I do use, instead of a nonstick gauze I use a gauze infused with colloidal silver and Neem salve. The salve is very easy to apply and painless unlike the toothpaste thick consistency creams others use.

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30 years ago I ended up with fungus 2 years in a row. 1st time was mostly limited to my arms and legs. The next year I got the fungus again this time it spread from arms and legs to the trunk of my body (but not to my bum). It took over a month to get rid of the infection. Don't know why I got fungus or where. I was allergic to sulfa and took another antifungal pill and I think I also had a Rx cream to apply.

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Invasive Candidiasis?
Global Emergence of Candida auris
Candida auris is an emerging multidrug-resistant type of Candida that presents a serious global health threat, including in the United States. It can cause severe infections and spreads easily in healthcare facilities.

Invasive candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Unlike Candida infections in the mouth and throat (also called “thrush”) or vaginal “yeast infections,” invasive candidiasis is a serious infection that can affect the blood, heart, brain, eyes, bones, and other parts of the body. Candidemia, a bloodstream infection with Candida, is a common infection in hospitalized patients.

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Agree, this needs to be cultured to find the organism causing the condition. Bacterial, fungal, viral....

The use of probiotics has been discussed in the medical literature.

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Sadly if this is Candidas it can lead to Sepsis which can be deadly.

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Reducing her carbohydrates (sugars and starches) may help. Fungi feed on carbs. There are people who eat no dietary carbs at all, and they thrive.

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I am only 70 and is otherwise good health. Last September, when I had my annual physical, I showed my doctor a yeast infection under my breasts that I'd had since August but hadn't been able to get rid of with cream Nystatin, which I keep on hand( I had had 3 very mild bouts years before, and the cream always worked). This time, she said the area was "too wet" (full of the serum your body makes in serious cases) to use cream at that point, so I am now on my eighth month of Nystatin powder and cream, plus the yeast infection spread all the way up to my chin, overlaid by horrible contact dermatitis. I had body-wracking fever and chills, often together, and sleepless nights, when the pain was so bad I couldn't find a comfortable sleeping position. I am hoping the last of both will go soon, especially since I am overdue for my annual mammogram and until recently, I couldn't have stood the pain of anyone touching my breasts. I was also given fluconazole at one point, which helped some but did not eliminate the yeast infection. Currently, I have the stubborn remnant between my breasts and a bit on my abdomen. The residual of the dermatitis is still visible, although no longer painful, and it is slowly going away. I had never had contact dermatitis in my life, and from what my doctors and I can tell, I had so much Nystatin, it got in my system - I could taste it!- eeyuk!!! -and my body reacted to it as an allergen. All of this is told to emphasize NOT to be stupid as I was and put off going to the doctor, just because you have an appointment soon or think you know how to handle a more serious version of an old problem. You CAN get sepsis if the yeast goes deeply enough - mine must have gotten into my system, because I had 4 cut-like marks that were open under my left breast, and when I applied Nystatin powder, it stung so badly, I could hardly stand it for up to half an hour. This gradually subsided and went away, but I will never take this lightly again. Unfortunately, once you have it, it seems easier to get it back. Take very good and careful care. She is lucky she has someone like you helping her.

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I have very large pendulous breasts. I have had mild yeast infections under them in the past.

What works for me,

Only wear a bra once before washing it. Soak my bras in a Borax solution before washing them in the machine. No mixed laundry.

Hang on clothes line for several hours.

I know I have not mentioned my body you, but avoiding reinfection is important.

I buy Boric Acid powder. Dissolve a tablespoonful in a cup of boiling water. Do not drink this, label it well as it will look like clear water.

Morning and night get a cotton ball or pad soaking wet in the solution and spread it under both breasts. TMI coming, I lay back on my bed and hold the girls out of the way, and let the solution dry naturally. In a few days it clears up completely.

A public health nurse told me about the benefits of healing yeast infections using Borax and Boric Acid when my infant daughter had a horrific Yeast based diaper rash. We had to put my DD into cloth diapers, used the same procedure for cleaning them that I use for my bras, wiped her bottom down with the Boric Acid solution and it cleared up quite quickly.

My DD got the yeast diaper rash as a nursling, when I had to take antibiotics for a stubborn Strep infection that lasted 6 weeks and took 2 courses of antibiotics to cure.

Why the cloth diapers? They are changed more frequently, if left without a plastic cover, they allow airflow.

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I get this from time to time on my upper trunk. I used dandruff shampoo and an OTC cream-Lotromin. It works for me. I don't know if it works with all fungal conditions, but my dermatologist said to try this, and it worked.

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My 90 year old mother had a severe yeast infection under her breasts for a year. It also started to spread. After her shower I would use a hair dryer on low heat under her breast to dry the area. I also purchased men’s white - Cotton -old fashioned handkerchiefs and rolled them up placing under her breasts to absorb the wetness. Changing when it became damp. Nystatin didn’t work for Mom. Aloe vista anti fungal and zinc oxide was our routine that cleared the problem up. Couldn’t find the aloe vista anti fungal local but ordered from the internet. The zinc oxide I used during night time as a barrier while sleeping.
we also cut back her sugar intake and added kefir to her diet daily. Good luck.

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Good ideas, Tharrison. Regular diaper rash ointment is zinc oxide, cheap, for sale everywhere. But also sugar intake is key. Especially soda, so much sugar!

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The info shared by others here is valuable. Candida is usually present in the gut - so treating systemically if possible is helpful. Many of the traditional meds like nystatin and diflucan cause side effects and can create resistant strains. I use a product called “candida support” by NOW. These are capsules that could also be added to her food if she resists swallowing. For her bum, mix oregano extract with coconut oil, or purchase it premixed as oregano oil. Works wonders from what I hear (just bought some myself to get rid of warts), and doesn’t sting or burn (which may be why she’s resistant) when diluted enough with the oil.

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Whilst a number of fungal infections can be treated with external products the easier way with people who do not want to co-operate is to switch them to oral medication. It is a long course - usually 12 weeks to 6 months but it relieves the fight, and possible ineffective level of treatment of externals and allows carers just to keep mum clean. It is imperative that they use a separate towel for that area, and a supply of those so they can be washed ideally daily is worth the investment if you have someone to wash them. Otherwise work it on however many you need for someone to be able to wash them (e.g. 14 and wash 7 once a week) - you only need hand towels after all. The most likely way to spread fungal infections is the use of the same washing/drying cloths on other parts of the body. To protect the skin around the affected area something that works as a barrier cream will help skin to not be affected by any weeping, and your Dr may be able to come up with a spray on rather than a cream - I don't know what you have in the US but in the UK we have antifungal spray powders which help to keep an area dry and have some medical effect as well - also avoid a lot of loss of dignity and being "played with" in private areas which can be a feeling in some patients.

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well when they change her they can put stuff on her, do they need to constantly say "okay we are going to put stuff on your butt".......no......just clean her off, put stuff on and then put the adult brief back on. my mother also had a pressure sore before going into nursing home because she did a lot of sitting and when she would get off chair, she would "scoot" off (until we got lift chair), which would make the skin thin......we got stuff to put on, kept it from getting worse. I haven't heard anything more about it being bad. I wish you luck

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This may be an insane response but I state what I feel and I am not holding back. I am no doctor but I have heard fungus is very difficult to treat and can cause terrible problems. If this woman is NOT cooperating, perhaps it will take two people to hold her down and address the issues and do what you have to do. Oh, she will scream and rant - so what? This is serious and it must be addressed - now - no matter what. She will rebel but that does not change the fact this must be taken care of. Don't give in - take control of people who are so stubborn and filled with dementia.

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Murphy18966: I do not profess to be a physician, but your mother may have to switch over to an oral medication so that at least she is receiving some form of medication, in lieu of it being wiped off onto bedding or feminine pads via a cream of ointment.

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Try an anti-fungal powder - sold at the drug store as foot powder. You also need a large powder puff. I couldn't find the old timey ones that used to be in the body powders online, but finally found a body powder gift box at Wmart. Dumped out the powder that came w/it and replaced with the foot powder. Worked wonders.

Also kept area drier - sitting most of the time keeps area damp/moist and a breeding ground for fungus and yeast issues.

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I use an Rx combo cream that is asteroid and antifungal. I fought a fungus in my wife's "belly fold" for weeks. to no avail This cleaned it up in about 3 days.

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My mom went through something similar for months - started as yeast then went to bacteria. She was on oral meds - Meplilex ag dressings - nystatin powder and creams - antifungal powder spray etc - it would start to heal and then rage again. I took her to the wound care center - he said it was not internal and was on her external skin (hence why oral meds didn’t work). He prescribed betadine on gauze and it has been the only thing that dried it up and made it heal. The first few weeks we used adaptic tape over the skin (so the baby gone new skin wouldn’t stick to the dressings and keep tearing open the wound as it healed ) then placed the gauze with betadine on it and bandaged wrapped her arm - it had to be changed every day then we worked down to every other day- I don’t know how to dress it or with what bandages in the area of her bottom
but I’m sure you could find a bandage to fit with betadine under it. I would request a wound care specialist consult - we did culture moms and the wound care dr said it was many species and it was on the skin and this was a way to dry it up as these areas are always so damp that all these creams made it worse. Best of luck

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