Re: possible lung fungus help
I guess there is nothing else to feel other than fear for a bronchoscopy before you have it done, but it's actually not as bad as you think. The sedation they give you doesn't exactly put you to sleep, BUT, the majority of people don't even remember the scope after it's done! Yes! Many people wake up going, "Hey, when are you doing to do the test?"
People on this thread have mentioned a bunch of things of different fungi, and the stories are all mixed up. I was hoping to be able to clarify some things. First of all, why does your doctor think you have fungus in your lungs? Is it because you have underlying lung disease and they found something on your CT scan? Or is it because you have asthma which is not responding to treatment and they want to find out if you have aspergillus? OR is it because you've been having fevers and stuff, and your CT chest is abnormal?
The reason I bring that up is because all of those syndromes (and more) are possible with fungus in the lung, but the approaches to their treatment is VERY different.
The most common fungi to infect the lung are Aspergillus species (a household mould) and "dimorphic fungi", which in Canada the two most common ones are Blastomyces and Histoplasma.
Here are some clinical scenarios where you could have fungus:
1. You have asthma which is not responding well to medical therapy and the respirologist wants to make sure you don't have Aspergillus in your lungs which could be causing an allergic reaction. This is called Allergic Bronchopulmonary Aspergillosis, it can mimic asthma and it is treated with steroids AND antifungals.
2. You have been having fevers and weight loss, and your CT chest shows some nodules and some other organs may be involved. This is usually how Histoplasma or Blastomyces act. These fungi live naturally in the ground in different parts of Canada, and in certain cases, if someone inhales enough of them, they can infect the lung and cause disease. In THIS type of condition, yes, you would treat with itraconazole (or another azole) for 6-12 months.
3. You have an underlying lung disease like bronchiectasis which has left large, eaten out cavities in your lungs. Some Aspergillus has gotten in to this cavity and formed a ball called a mycetoma. This is common in people who have old cavities in their lungs, and does NOT need to be treated with antifungals. If the person is having a lot of lung bleeding, then sometimes you may need to actually surgically remove part of the lung.
4. You have a compromised immune system (HIV or on chemotherapy for cancer), have developed a fever and there are some abnormalities on your chest x-ray and/or CT chest. This situation is high risk for Aspergillus affecting the lung. Usually you could treat this with an azole (such as voriconazole) for 6 months or until the person is symptomatically better.
Soooo, that's a lot of stuff I have just thrown at you, and those definitely aren't the only ways people can have fungus in the lung. Do any of those situations apply to you?
Last edited by harka; 08-25-2008 at 02:29 PM.