remicade and a positive urine histoplasmosis

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chroniemomx2
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Date Joined Apr 2005
Total Posts : 2346
   Posted 6/19/2008 9:02 PM (GMT -6)   
I am on remicade, and every year my gi has me do this test.  This year I tested positive for it.  Now I have to go see an infectious disease dr. to see what he has to say about me conitinuing remicade.
 
Has anybody else ever tested positive for this?  If so, what did you do?

quincy
Elite Member


Date Joined May 2003
Total Posts : 30677
   Posted 6/20/2008 12:30 AM (GMT -6)   
Hi...wow, I've definitely heard of histoplasmosis...in my mind it's "bird poop disease"...a specific contagious fungus that affects the lungs from breathing in the specific spores. That's not a good thing.

How long do you have to wait before seeing the infectious disease doctor?

Did your GI take the test?

I hope you'll do a lot of research on it and in regards to being on a biologic such as Remicade so that you'll be armed with a list of questions and ready for responses from the doctor.

Please, please keep us abreast of your situation....

quincy


*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!

Post Edited (quincy) : 6/20/2008 12:52:33 PM (GMT-6)


chroniemomx2
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Date Joined Apr 2005
Total Posts : 2346
   Posted 6/20/2008 6:20 AM (GMT -6)   
lol....yes it is the bird poop disease! Lovely, huh?! lol I'm not contagious, so that is a good thing, and I don't have any symptoms. My gi called it a weak positive. Anything above a 2 is positive, and mine was 2.6. My gi does the test every yr because I live in Michigan and according to her it is pretty prevelant. The first available apt. with the inf. disease dr was July 1st. And I have asked for a referrel to an infect. disease dr at U of M also for a second opinion.

What I have found so far, is that the cases of this back in 2001, people contracted it pretty quickly after starting remicade. And I have been on it for almost 4 years.

lemonhead
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Date Joined Dec 2007
Total Posts : 1028
   Posted 6/20/2008 6:30 AM (GMT -6)   
Oh yes, histoplasmosis.  Gotta love it.  I work with it every day in the infectious diseases department her at Universtiy of Cincinnati.  That is the only reason I am not on remicade right now.  I would have had to quit my job to start it.  Anyway, beside being the bird poop disease, it is also found in soil, dust, you name it.  Very prevelant along the mississippi river valley and anywhere there is a lot of water....mostly midwest states.  Although it can be very bad....deadly in some.  It is usually very well treated.  And you caught yours early.  The sooner the better to get in to the infectious diseases doc because it can cause some damage to your eyes.  I do basic research on histo, so I am not sure of the meds for it, but I can ask my boss if you are interested in what you may have to be on.  Don't worry all the people that I know that have gotten it after Remi have been fine.  Once you have been exposed to it, you already have the antibodies to it, the remi just prevents them from working.  But you will be Ok,  It usually starts with mild cold like symptoms, are you having any of those?  If you do start to have those, see your doc asap, just to be on the safe side....but you will be fine, don't strss too much over it.  if you have any questions, let me know and I will try to get them answered for you.

diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 6/20/2008 6:41 AM (GMT -6)   
Oh wow, thanks lemonhead! So, is it something that once I test positive, I'll always test positve forever? Have your remicade patients ha to stop taking the remicade because of it? No, I'm not having any symptoms. I have read that it wasn't contagious, so why can't you take remicade???

lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 6/20/2008 7:00 AM (GMT -6)   
The remicade essentially stops your own immune system from taking care of the fungal infection. It is not contagous, nor will you ever find out how you got. Frusterating because wouldn't it be nice to know so you don't do it again. But it could have been cleaning the attic, or planting flowers, or any number of things. I don't know if they will stop the remicade for a while or not. I will ask about that. I do basic research, so I have no patient contact, but my boss is an infectious disease doc and an "expert" on histo. I will ask him. I know when the remicade discussion came up with regards to my UC management plan, he told me we flat out that I could NOT work with histo if I took it. I think remicade is a TNF-alpha blocker??? Histo needs TNF to fight the infection. I think in your case if you have lived in Michigan for some time, you have already been exposed to histo, and if you were not on remicade, no problem for your body to fight the fungus and clear your system of it. But since you are on Remicade, it will be a challenge for you to clear the fungus on your own. But again, you have very, very low levels in your system right now, so I would not worry about it until you see the ID doc. When I get to work I will talk to my boss and get you some more concrete information. Give me a couple of hours to get there and track him down, and I will let you know what he saya.
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 6/20/2008 7:05 AM (GMT -6)   
You are the best! Thanks you sooooo much! I certainly appreciate your help! I would certainly be interested in knowing what your boss thinks about me continuing the remicade.

I have lived in MI all my life except for when I went to college.

ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 6/20/2008 7:25 AM (GMT -6)   
Interesting! I've heard of toxoplasmosis but not histo, or not much anyway. So, if I were to go on Remicade, and say I am dusting my house or repotting my orchids, would I be at a significant risk for it (even though I live in Florida)?? Are there precautions to take to prevent it, like washing your hands immediately afterwards or wearing gloves, or is it more likely you'll just inhale it anyway??

I hope they get it figured out for you and get you on treatment quick, chroniemom!
Female, 22, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in hip & lumbar region of the spine from long term prednisone use.

Current Meds:
10mg Lexapro (for depression/social anxiety)
Digestive Advantage: Crohn's and Colitis formula (2 pills per day, started 5/14/08)
125mg Azathioprine
4800mg Asacol (Four 400mg tablets, three times a day)
 
 
 


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 6/20/2008 7:32 AM (GMT -6)   
Thanks! You contract it by inhalation only...at least from what I have read. I would assume FL would be a risk state also, with all of the lakes, and birds, and I would assume it would be more or a risk since you don't have the winters we have up here....but I have nothing to base my assumptions on. :) Remicade has given me my life back, so I would do it all over again if I had too, but I'm just hoping that I can continue on it, and don't have to stop it.

bookworm21
Veteran Member


Date Joined Mar 2008
Total Posts : 1766
   Posted 6/20/2008 7:37 AM (GMT -6)   
Hmmm, I just had my first Remicade infusion and now I'm having cold symptoms...I'm going to be paranoid now. I do (sorda) live near the Ohio River but I haven't done any planting or cleaning dusty places. Should GI's be checking for this everytime we have an infusion?
 
chroniemom, I hope you feel better and figure out what to do!
Female, Age 19, Dx w/ UC August 2007
9 Asacol, Rowasa1000 mg Canasa, Proctofoam, Rifaximin 2/day
Digestive Advantage (Crohn's & Colitis), 1 Florastor, 50 mg 6MP,1 Primadophilus reuteri, 1 DanActive, Remicade (1st infusion 06/08), 2.4 g Lialda


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 6/20/2008 7:42 AM (GMT -6)   
Thanks!

I hadn't done any planting, or cleaning either....

Mine only checks once a year.

quincy
Elite Member


Date Joined May 2003
Total Posts : 30677
   Posted 6/20/2008 1:50 PM (GMT -6)   
It's in the soil, and the bird poo makes the soil the right ph for the fungus to grow.....the spores are then released and if one is in a situation where this is available, one will most likely contract it.
 
Apparently birds don't actually carry it....it's their wonderful poo that is the "fertiliser" for the specific fungus (forget the name).
 
Bats, on the other hand, can contract it by breathing it in.....but they also carry it and can spread it through their poo.....so, it is contagious that way.
 
Apparently, it's not spread via humans.....seems a good thing.  
 
One article I read stated that asymptomatic people don't need to be treated, but those who are immunocompromised, regardless of whether they're asymptomatic, should be treated.
 
I just suggest you do the research...lots of it....and be ready for your appointment.  Not all doctors may have the same philosophy about treatment, etc.
 
Keep us posted,
quincy


*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 6/20/2008 5:27 PM (GMT -6)   
Spoke with my boss and amphoteracin (spelling?) would be what you would treat with. It is no walk in the park....side effects are not so wonderful, and there is a chance they will stop your iinfusions for a short while until the histo infection clears....then you can start right back up.
I am off to dinner with my hubby....no kids tonight, but after I will try to dig up some info on the medication used to treat histo.

Also, for everyone on Remi....just because you have cold symptoms does not mean you are getting a histo infection......it could just be a cold. But the issue is that tnf alpha is essential for fighting histo infections, when you take remi, it blocks tnf (which helps inflammation) therefore making histo run rampant in your system. It is fatal if not treated, so be advised that if you are on remicade and you live in the areas were histo is prevalent, get the urine test.....every 6 months.

I will post details later. Hope you are all feeling well.
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 6/20/2008 9:06 PM (GMT -6)   
http://www.drugs.com/cdi/amphotec.html
for drug

http://www.spondylitis.org/press/news/039.aspx
histo and remi information

If there is anything else I can help you answer, please let me know. Also, I will be nterested to hear what your ID doc recommends. Good luck.
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 6/21/2008 10:03 PM (GMT -6)   
Thanks for the info lemonhead! I certainly appreciate it! I went to the beach for the weekend, and there was this little kid chasing the seagulls towards me, and i was about ready to yell at him! lol

My gi dr. ran into the id dr. at the hospital while they were doing rounds so they talked, and he wants a repeat urine to make sure it wasn't a false positive. They also ordered some labs, and a chest xray. I did all of that on Fri. before I left, so we will see next week what comes of all of that.

Thanks again lemonhead! You certainly went above and beyond to help me. I appreciate it!

lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 6/22/2008 10:36 AM (GMT -6)   

Anything I can do help my fellow UCers, I will gladly do.  The chest x-ray will show if you have an active infection.  But be advised that if you have been exposed to histo in the past....and I am sure you have, you could see something on the x-ray.  It is  lile reisual histo has left a scar there.  Here in Cincy it is widely known that Pete Rose had unnecessary surgery on his lungs for a hist scar that was inactive.  I assumed they would do another urine to double check and just to see what your current levels are.  Sounds like you are getting great care.  I will just hope that you don't have to stop the remi as I know that is helping you tremendously.


diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 6/22/2008 9:24 PM (GMT -6)   
Actually I have crohns....but mainly just my lg bowel and rectal area, so I have that in common with you all. :) I wasn't getting any info on the crohns board, so I posted over here, and you guys have alot more to say about it for which I am very thankful!

I have had previous cxr, so I'm assuming they would compare my one on Fri., to my other ones. When I get my tests back, I'll let you know how everything checks out.
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