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Ask the Experts about Opportunistic Infections
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Yeast Infection, immune suppression, HIV
May 24, 2000

Hi,

I have a fungal infection which does not seem to go away even after 20 days of Sporanox treatment and 50 days of diflucan infection. Before the treatment my doctor conducted a test in which I had a heavy quantity of yeast and the yeast was multiplying. In an immune test before the treatment began I got the - WBC count as 4.4 k/ul - lymphocyte count as 30.5% %CD3+ (T-CELLS) AS 76.8% %CD3+ / DR+ (ACT. T-CELLS) AS 0.6 %CD3+/CD4+ (T-HELPER) AS 36.0 % %CD8+/CD57+ AS 3.2% %CD8+/CD38+ AS 3.8% ABSOLUTE LYMPHOCYTE COUNT AS 1342 /MM3 TOTAL T CELLS 1031 /mm3 TOTAL ACTIVATED T CELL AS 8 /MM3 TOTAL T-HELPER CELLS AS 483 /MM3 TOTAL T-SUPPRESSOR CELLS AS 431 /MM3 TOTAL CD8+/CD38+ CELLS AS 51 /MM3 HELPER/SUPPRESSOR RATIO AS 1.12 Could it be that I have HIV (I have no reason to believe that except that whenever I look for yeast infection I find HIV as a possible cause) ? I have an irritable bowel too. In a book on the yeast syndrome I read that the yeast can also cause immune suppression if it crosses the intestinal boundary and enters the blood. I believe my yeast infection to be due to antibiotic abuse for many years. It would be a great gesture on your part if you could help me by giving some pointers on how to treat this infection (i.e getting a specialist who knows the latest methods of diagnosing and treating fungal infection in Maryland, Montgomery County - Rockville / Gaithersburg cities). I have no idea where to go and this problem is driving me crazy because instead of healing it is spreading.

Thanks a lot,

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   Response from Dr. Feinberg

Your T cell profile looks normal. Yeast infections do not cause immune suppression -- it's the other way around. But just as you said, chronic antibiotic use will kill off the bacteria that are supposed to live in your body and will allow the yeasts to overgrow, causing infection. Overuse of antifungal medications may just cause resistance.

You don't say where this fungal infection is located, and some fungal infections -- especially of the nails and sometimes the skin -- can take a long time to get rid of.

There are excellent infectious diseases physicians in the suburban Washington area (I used to live and work there). You have access to faculty at local medical schools such as George Washington, Georgetown and Hopkins. There are good local ID docs in practice in Bethesda (check the phone book).



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