question-icon

Suggest treatment for recurrent yeast infection

default
Posted on Tue, 28 Jun 2016
Question: I am 67, female and in generally good health. I have been very conscious my weight and lost 55 lbs in the last half yeat. I do have one thing, I have yeast women's infection that comes and goes. But my big problem is that I had a very badly broken leg and got a yeast infection at the site of the top fixator holding my leg together. It was treated with triple antibiotic. It was not better when the cast was put on.
When we removed my cast -- I started treating the wound for yeast infection; It itched non stop and weeped non stop -- causing itching wherever it the fluid touched. So, I used Monistat and a bandage - immediately it got much better. When I thought it was fine - I took the bandage off -- two days later it was open and weeping again. So I retreated and left on for a week. The sore is better. Now under it the flesh is cool, but it is swollen and painful. It is now also painful when I put weight on my foot (I am supposed to now) my shin screams with pain.
My foot, ankle and two leg bones have healed GREAT - BUT.....my shin is keeping me from putting any weight on that leg. The deep pain is exactly behind the scar from the fixator; and right in front of or akin to the hole that is visible on the x-ray.
My regular doctor ran a CBC for me -- it came back perfect (I am a little anemic),
Is a CBC a good indicator for a systemic yeast infection? of any kind of yeast infection?
The regular appointment to the fracture clinic yesterday I was told that everything is fine and to use 100% of my weight on my leg now, with ankle brace and shoe. (Prior to that I was in a removable cast for 4 weeks, the last two week encouraged to use 50% weight with walker, do-able but painful).

Any advise on other test, or other things to do? I cannot get into see the surgeon for a few weeks.

I didn't say that I will see the surgeon in a few weeks

doctor
Answered by Dr. Tushar Kanti Biswas (8 hours later)
Brief Answer:
Yeast infection

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns. Yes I've reviewed the reports too..

Yeast infection caused by the fungus candida will not cause any change in CBC (generally remains normal).

You have only Cutaneous Candidiasis (wound infection).There does not appear to be any feature of systemic Candidiasis (Hematogenous Dissemination).

Moreover patients with chronic mucocutaneous candidiasis rarely develop hematogenously disseminated candidiasis, probably because their neutrophil function remains intact (CBC in your case is normal).

For cutaneous Candidiasis -Topical azole,Topical nystatin are treatment of choice and you are already applying/dressing along with Monistat (tioconazole).

Approximately half of patients with chronic mucocutaneous candidiasis have associated endocrine abnormalities .

Since the yeast infection is chronic now,you can undergo Thyroid function tests e.g Serum T3,T4 & TSH to exclude associated autoimmune thyroiditis, Graves’ disease.







Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Tushar Kanti Biswas (4 days later)
Thank you very much.
Your suggestion about Thyroid is something I will have checked.

I did not mention that I have Sjogren's Syndrome the auto immune things associated with that might be part of the problem. I have skin that is very dry (almost like my mother's Ichthyosis), and the dry eyes, nose, and mouth. I have now been dx with rheumatoid arthritis too. It never occurred to me that auto immune things could be involved in healing and chronic yeast.

Thank you for the heads up. I have pushed harder and I got an appointment to see the surgeon that did the surgery. I will see her this week. The others that I see are nurses and PA's they have not taken this very seriously and continue with the schedule for the broken leg and ankle - that part is fine -- oh well, I am going to see the doctor now.

I was in the hospital for over a month after the broken bones, this is pretty much unheard of in this time and place. They did an amazing job on my breaks ( five in the ankle and 4 in the legs) - but I think the infection goes all the way through the higher part of the anterior tibialis and into the tibia - - where the temporary exterior fixator's first hole can be seen on the x-ray.

I am now putting full weight on the leg, but it produces the sharpest pain imaginable at the sight of the infection. (which right now it "healed" over, but I can feel another big lump forming under the scar). Nothing else from the surgery and repairs hurts at all. Strange.

I am going to ask the surgeon to refer me to an infection doctor who can take a broader look at this thing. What kind of doctor does that kind of thing?

Your information is very helpful, thank you -- XXXX
doctor
Answered by Dr. Tushar Kanti Biswas (1 hour later)
Brief Answer:
Yeast infection & Autoimmune Diseases

Detailed Answer:
You can additionally consult infectious disease specialist for Yeast infection.

Sjögren’s Syndrome can be associated with other Autoimmune Diseases like Rheumatoid arthritis as in your case.
Vasculitis affects small and medium-sized vessels in Sjögren’s Syndrome and may cause skin ulcerations albeit delayed wound healing.

Regards

Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for recurrent yeast infection

Brief Answer: Yeast infection Detailed Answer: Hi, Thank you for your query. I can understand your concerns. Yes I've reviewed the reports too.. Yeast infection caused by the fungus candida will not cause any change in CBC (generally remains normal). You have only Cutaneous Candidiasis (wound infection).There does not appear to be any feature of systemic Candidiasis (Hematogenous Dissemination). Moreover patients with chronic mucocutaneous candidiasis rarely develop hematogenously disseminated candidiasis, probably because their neutrophil function remains intact (CBC in your case is normal). For cutaneous Candidiasis -Topical azole,Topical nystatin are treatment of choice and you are already applying/dressing along with Monistat (tioconazole). Approximately half of patients with chronic mucocutaneous candidiasis have associated endocrine abnormalities . Since the yeast infection is chronic now,you can undergo Thyroid function tests e.g Serum T3,T4 & TSH to exclude associated autoimmune thyroiditis, Graves’ disease. Regards Dr. T.K. Biswas M.D. XXXXXXX