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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

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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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Warriorforthem Jun 2021
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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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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Murphy18966 Jun 2021
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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Murphy18966 Jun 2021
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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Murphy18966 Jun 2021
Pills? That would be easier for sure. Thank you
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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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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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Tothill Jun 2021
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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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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Murphy18966 Jun 2021
Thank you!
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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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Sendhelp Jun 2021
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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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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BetseyP Jun 2021
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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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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