Fungal infections of the bile in PSC

[Guest guest]

,

My doc gave me Flagyl a couple of times, along with Levaquin for a cholangitis infection...maybe this is why. Many years ago I had some serious issues as a result of candida, and was forced to change my diet...really my whole lifestyle. I was told during this last inpatient stay, that the Neomycin I take for H.E. clears the flora out INSTANTLY. Also, with the additional antibiotics (Levaquin, Augmentin, and Rifampin) I'm candida's dream. So, the ER and the in-house doc told me I should get better probiotics than the ones I am taking and I was recommended Primal Defense. I had a friend pick me up some yesterday and took my first dose last night. I'm planning to show improvement in my overall health soon...according to them I will notice a change for the better pretty quick. I know this won't cure me, but any improvement is always exciting.

Thanks for posting this article.

(MO)PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05for details see www.caringbridge.org/visit/melaniejs

[Guest guest]

,

My doc gave me Flagyl a couple of times, along with Levaquin for a cholangitis infection...maybe this is why. Many years ago I had some serious issues as a result of candida, and was forced to change my diet...really my whole lifestyle. I was told during this last inpatient stay, that the Neomycin I take for H.E. clears the flora out INSTANTLY. Also, with the additional antibiotics (Levaquin, Augmentin, and Rifampin) I'm candida's dream. So, the ER and the in-house doc told me I should get better probiotics than the ones I am taking and I was recommended Primal Defense. I had a friend pick me up some yesterday and took my first dose last night. I'm planning to show improvement in my overall health soon...according to them I will notice a change for the better pretty quick. I know this won't cure me, but any improvement is always exciting.

Thanks for posting this article.

(MO)PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05for details see www.caringbridge.org/visit/melaniejs

[Guest guest]

,

My doc gave me Flagyl a couple of times, along with Levaquin for a cholangitis infection...maybe this is why. Many years ago I had some serious issues as a result of candida, and was forced to change my diet...really my whole lifestyle. I was told during this last inpatient stay, that the Neomycin I take for H.E. clears the flora out INSTANTLY. Also, with the additional antibiotics (Levaquin, Augmentin, and Rifampin) I'm candida's dream. So, the ER and the in-house doc told me I should get better probiotics than the ones I am taking and I was recommended Primal Defense. I had a friend pick me up some yesterday and took my first dose last night. I'm planning to show improvement in my overall health soon...according to them I will notice a change for the better pretty quick. I know this won't cure me, but any improvement is always exciting.

Thanks for posting this article.

(MO)PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05for details see www.caringbridge.org/visit/melaniejs

[Guest guest]

Diane,

Prayers are coming your way!!!

(MO)PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05for details see www.caringbridge.org/visit/melaniejs

[Guest guest]

Diane,

Prayers are coming your way!!!

(MO)PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05for details see www.caringbridge.org/visit/melaniejs

[Guest guest]

Dear All;

I thought that this article would be of potential interest to those

suffering from persistent cholangitis. Whereas bacterial infections

are the most common cause, this report shows that fungal infections

with Candida species can also occur in PSC:

__________________________

J. Hepatol. [in Press] (2006)

Biliary Candida infections in primary sclerosing cholangitis.

Hasan Kulaksiz, Gerda Rudolph, Petra Kloeters-Plachky, Sauer,

Heinrich Geiss, Adolf Stiehl

Received 6 June 2006; received in revised form 4 July 2006; accepted

13 July 2006 published online 10 August 2006.

Uncorrected Proof

Abstract

Background/Aims

Patients with Primary Sclerosing Cholangitis (PSC) frequently

develop dominant stenoses of the bile ducts and bacterial infections

represent a major problem in such patients. In the present study,

the role of fungal infections of the bile ducts has been evaluated.

Methods

In a prospective non-randomized trial, in 67 consecutive patients

with PSC, 148 bile samples, each taken at one endoscopic

examination, were microbiologically analysed.

Results

Candida species were found in 8/67 patients whereas Aspergillus was

not detected. Seven patients with biliary Candida had a dominant

stenosis and one had a wide papillotomy with chronic ascending

cholangitis. Altogether 7/49 of patients with dominant stenosis and

1/18 of patients without dominant stenosis had Candida in their

bile. All patients with biliary Candida intermittently had received

antibiotics and had advanced disease with cholestasis. Candida

disappeared spontaneously in 2/7 patients, cleared after antifungal

treatment in 2, and persisted in 3 patients. Patients with biliary

Candida had more severe cholangitis with higher CRP and serum

bilirubin compared to those without Candida infection.

Conclusions

This is the first report on the identification of Candida species in

the bile of patients with PSC. Apart from bacterial also fungal

infection of the bile ducts should be considered in the treatment of

such patients.

Keywords: Sclerosing cholangitis, Candida infection, Biliary

disease, Cholestasis, Liver disease, Ursodeoxycholic acid

Department of Medicine, University of Heidelberg, Medizinische

Universitätsklink, Im Neuenheimer Feld

410, D-69120 Heidelberg, FRG, Germany

Corresponding author. Tel.: +49 6221 568707; fax: +49 6221 565687.

PII: S0168-8278(06)00410-7

doi:10.1016/j.jhep.2006.07.022

__________________________

Best regards,

Dave

(father of (21); PSC 07/03; UC 08/03)

[Guest guest]

Very interesting! Husband, Brad, spent a few weeks in hospital for

bile duct leak after surgeon nicked bile duct during liver biopsy.

Anyway, bad to worse, after his release from hospital, his GI called

and said to come in to be admitted. Brad had developed candida. A

friend said, " oh, it's just a yeast infection. " Candida in the

bloodstream can cause all types of problems. Brad ended up with

nodules in his lungs which were the result of the infection. Candida

can also cause problems with the eyes, among many other things. The

infection was treated effectively, but he remained in the hospital for

3 days for treatment. He was under care of an infectious disease doc

who said it could have been the result of infection through the PICC

line, or something to do with the high lipids in the TPN Brad had

received over the weeks.

We're flying to Mayo next week. Brad gets to see Dr. Gores regarding

his PSC/Cholangiocarcinoma. " Hope " is a natural anti-depressant.

Prayers are welcome.

Diane

[Guest guest]

Very interesting! Husband, Brad, spent a few weeks in hospital for

bile duct leak after surgeon nicked bile duct during liver biopsy.

Anyway, bad to worse, after his release from hospital, his GI called

and said to come in to be admitted. Brad had developed candida. A

friend said, " oh, it's just a yeast infection. " Candida in the

bloodstream can cause all types of problems. Brad ended up with

nodules in his lungs which were the result of the infection. Candida

can also cause problems with the eyes, among many other things. The

infection was treated effectively, but he remained in the hospital for

3 days for treatment. He was under care of an infectious disease doc

who said it could have been the result of infection through the PICC

line, or something to do with the high lipids in the TPN Brad had

received over the weeks.

We're flying to Mayo next week. Brad gets to see Dr. Gores regarding

his PSC/Cholangiocarcinoma. " Hope " is a natural anti-depressant.

Prayers are welcome.

Diane

[Guest guest]

I wonder if this could have any relation to the fact that 's last 3 bronchoscopies have shown candida, despite the fact that he's been on fluconazole since the 3rd bronch back?!? Ami wrote: Dear All;I thought that this article would be of potential interest to those suffering from persistent cholangitis. Whereas bacterial infections are the most common cause, this report shows that fungal infections with Candida species can

also occur in PSC:__________________________ J. Hepatol. [in Press] (2006)Biliary Candida infections in primary sclerosing cholangitis.Hasan Kulaksiz, Gerda Rudolph, Petra Kloeters-Plachky, Sauer, Heinrich Geiss, Adolf StiehlReceived 6 June 2006; received in revised form 4 July 2006; accepted 13 July 2006 published online 10 August 2006. Uncorrected ProofAbstractBackground/AimsPatients with Primary Sclerosing Cholangitis (PSC) frequently develop dominant stenoses of the bile ducts and bacterial infections represent a major problem in such patients. In the present study, the role of fungal infections of the bile ducts has been evaluated.MethodsIn a prospective non-randomized trial, in 67 consecutive patients with PSC, 148 bile samples, each taken at one endoscopic examination, were microbiologically analysed.ResultsCandida species were found in

8/67 patients whereas Aspergillus was not detected. Seven patients with biliary Candida had a dominant stenosis and one had a wide papillotomy with chronic ascending cholangitis. Altogether 7/49 of patients with dominant stenosis and 1/18 of patients without dominant stenosis had Candida in their bile. All patients with biliary Candida intermittently had received antibiotics and had advanced disease with cholestasis. Candida disappeared spontaneously in 2/7 patients, cleared after antifungal treatment in 2, and persisted in 3 patients. Patients with biliary Candida had more severe cholangitis with higher CRP and serum bilirubin compared to those without Candida infection.ConclusionsThis is the first report on the identification of Candida species in the bile of patients with PSC. Apart from bacterial also fungal infection of the bile ducts should be considered in the treatment of such

patients.Keywords: Sclerosing cholangitis, Candida infection, Biliary disease, Cholestasis, Liver disease, Ursodeoxycholic acidDepartment of Medicine, University of Heidelberg, Medizinische Universitätsklink, Im Neuenheimer Feld 410, D-69120 Heidelberg, FRG, GermanyCorresponding author. Tel.: +49 6221 568707; fax: +49 6221 565687.PII: S0168-8278(06)00410-7doi:10.1016/j.jhep.2006.07.022__________________________ Best regards,Dave (father of (21); PSC 07/03; UC 08/03)Ami mom to - 8 yrs old - Double Lung Tx 2/26/2006, PSC - Pre-Liver Tx, Central DI, Steroid Induced Diabetes, HypoT, GERD, High Blood Pressure, ADD, Anemia, Malabsorption, Slow Motility http://www.caringbridge.com/visit/seanfox mom to Emma - 12 yrs old - Migraines, otherwise good & healthy (thankfully) stepmom to - 13 yrs old - ADD, RAD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Adverse circumstances test our courage, our strength of mind, and the depth of our conviction in the Dharma. There is nothing exceptional about practicing Dharma in a good environment and atmosphere. The true test is if we can maintain our practice in adverse conditions.-Geshe Ngawang Dhargyey, "Advice From a Spiritual Friend"

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

I wonder if this could have any relation to the fact that 's last 3 bronchoscopies have shown candida, despite the fact that he's been on fluconazole since the 3rd bronch back?!? Ami wrote: Dear All;I thought that this article would be of potential interest to those suffering from persistent cholangitis. Whereas bacterial infections are the most common cause, this report shows that fungal infections with Candida species can

also occur in PSC:__________________________ J. Hepatol. [in Press] (2006)Biliary Candida infections in primary sclerosing cholangitis.Hasan Kulaksiz, Gerda Rudolph, Petra Kloeters-Plachky, Sauer, Heinrich Geiss, Adolf StiehlReceived 6 June 2006; received in revised form 4 July 2006; accepted 13 July 2006 published online 10 August 2006. Uncorrected ProofAbstractBackground/AimsPatients with Primary Sclerosing Cholangitis (PSC) frequently develop dominant stenoses of the bile ducts and bacterial infections represent a major problem in such patients. In the present study, the role of fungal infections of the bile ducts has been evaluated.MethodsIn a prospective non-randomized trial, in 67 consecutive patients with PSC, 148 bile samples, each taken at one endoscopic examination, were microbiologically analysed.ResultsCandida species were found in

8/67 patients whereas Aspergillus was not detected. Seven patients with biliary Candida had a dominant stenosis and one had a wide papillotomy with chronic ascending cholangitis. Altogether 7/49 of patients with dominant stenosis and 1/18 of patients without dominant stenosis had Candida in their bile. All patients with biliary Candida intermittently had received antibiotics and had advanced disease with cholestasis. Candida disappeared spontaneously in 2/7 patients, cleared after antifungal treatment in 2, and persisted in 3 patients. Patients with biliary Candida had more severe cholangitis with higher CRP and serum bilirubin compared to those without Candida infection.ConclusionsThis is the first report on the identification of Candida species in the bile of patients with PSC. Apart from bacterial also fungal infection of the bile ducts should be considered in the treatment of such

patients.Keywords: Sclerosing cholangitis, Candida infection, Biliary disease, Cholestasis, Liver disease, Ursodeoxycholic acidDepartment of Medicine, University of Heidelberg, Medizinische Universitätsklink, Im Neuenheimer Feld 410, D-69120 Heidelberg, FRG, GermanyCorresponding author. Tel.: +49 6221 568707; fax: +49 6221 565687.PII: S0168-8278(06)00410-7doi:10.1016/j.jhep.2006.07.022__________________________ Best regards,Dave (father of (21); PSC 07/03; UC 08/03)Ami mom to - 8 yrs old - Double Lung Tx 2/26/2006, PSC - Pre-Liver Tx, Central DI, Steroid Induced Diabetes, HypoT, GERD, High Blood Pressure, ADD, Anemia, Malabsorption, Slow Motility http://www.caringbridge.com/visit/seanfox mom to Emma - 12 yrs old - Migraines, otherwise good & healthy (thankfully) stepmom to - 13 yrs old - ADD, RAD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Adverse circumstances test our courage, our strength of mind, and the depth of our conviction in the Dharma. There is nothing exceptional about practicing Dharma in a good environment and atmosphere. The true test is if we can maintain our practice in adverse conditions.-Geshe Ngawang Dhargyey, "Advice From a Spiritual Friend"

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

I wonder if this could have any relation to the fact that 's last 3 bronchoscopies have shown candida, despite the fact that he's been on fluconazole since the 3rd bronch back?!? Ami wrote: Dear All;I thought that this article would be of potential interest to those suffering from persistent cholangitis. Whereas bacterial infections are the most common cause, this report shows that fungal infections with Candida species can

also occur in PSC:__________________________ J. Hepatol. [in Press] (2006)Biliary Candida infections in primary sclerosing cholangitis.Hasan Kulaksiz, Gerda Rudolph, Petra Kloeters-Plachky, Sauer, Heinrich Geiss, Adolf StiehlReceived 6 June 2006; received in revised form 4 July 2006; accepted 13 July 2006 published online 10 August 2006. Uncorrected ProofAbstractBackground/AimsPatients with Primary Sclerosing Cholangitis (PSC) frequently develop dominant stenoses of the bile ducts and bacterial infections represent a major problem in such patients. In the present study, the role of fungal infections of the bile ducts has been evaluated.MethodsIn a prospective non-randomized trial, in 67 consecutive patients with PSC, 148 bile samples, each taken at one endoscopic examination, were microbiologically analysed.ResultsCandida species were found in

8/67 patients whereas Aspergillus was not detected. Seven patients with biliary Candida had a dominant stenosis and one had a wide papillotomy with chronic ascending cholangitis. Altogether 7/49 of patients with dominant stenosis and 1/18 of patients without dominant stenosis had Candida in their bile. All patients with biliary Candida intermittently had received antibiotics and had advanced disease with cholestasis. Candida disappeared spontaneously in 2/7 patients, cleared after antifungal treatment in 2, and persisted in 3 patients. Patients with biliary Candida had more severe cholangitis with higher CRP and serum bilirubin compared to those without Candida infection.ConclusionsThis is the first report on the identification of Candida species in the bile of patients with PSC. Apart from bacterial also fungal infection of the bile ducts should be considered in the treatment of such

patients.Keywords: Sclerosing cholangitis, Candida infection, Biliary disease, Cholestasis, Liver disease, Ursodeoxycholic acidDepartment of Medicine, University of Heidelberg, Medizinische Universitätsklink, Im Neuenheimer Feld 410, D-69120 Heidelberg, FRG, GermanyCorresponding author. Tel.: +49 6221 568707; fax: +49 6221 565687.PII: S0168-8278(06)00410-7doi:10.1016/j.jhep.2006.07.022__________________________ Best regards,Dave (father of (21); PSC 07/03; UC 08/03)Ami mom to - 8 yrs old - Double Lung Tx 2/26/2006, PSC - Pre-Liver Tx, Central DI, Steroid Induced Diabetes, HypoT, GERD, High Blood Pressure, ADD, Anemia, Malabsorption, Slow Motility http://www.caringbridge.com/visit/seanfox mom to Emma - 12 yrs old - Migraines, otherwise good & healthy (thankfully) stepmom to - 13 yrs old - ADD, RAD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Adverse circumstances test our courage, our strength of mind, and the depth of our conviction in the Dharma. There is nothing exceptional about practicing Dharma in a good environment and atmosphere. The true test is if we can maintain our practice in adverse conditions.-Geshe Ngawang Dhargyey, "Advice From a Spiritual Friend"

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

,

I have yeast on my tongue and take Acidophilus for it...I saw your email

am going to the Vitamin Shoppe and get it.

Thanks for mentioning it.

in Ga. from Ohio

[Guest guest]

,

I have yeast on my tongue and take Acidophilus for it...I saw your email

am going to the Vitamin Shoppe and get it.

Thanks for mentioning it.

in Ga. from Ohio

[Guest guest]

,

I have yeast on my tongue and take Acidophilus for it...I saw your email

am going to the Vitamin Shoppe and get it.

Thanks for mentioning it.

in Ga. from Ohio

[Guest guest]

Jarad, and anyone else interested in the Candida issue. When I was first diagnosed with PSC 20 years ago and in desperate shape (my primary bile duct had been almost totally blocked with a dominant stricture for who knows how long) I had terrible problems with yeast overgrowth in the mouth and on the tongue for about two years prior to being opened up and stented with a T-tube. Candida in the mouth (thrush) is pretty easily recognizable and usually looks like the tongue is white and furry sometimes with scattered red patches, sometimes not. Often the tongue will be sore as well. Also, the overgrowth can show up in the mucous membranes of your mouth and your gums. To the tongue, it will feel like the skin inside your mouth is slightly bumpy and sometimes like it's peeling off. Once the stent was placed in my primary duct (at that time I only had a few strictures, now you can't count them!), these symptoms cleared within a week! But through the course of 2 years prior to that I used plain Nystatin powder, probiotics, and diet (simple sugars are the worst for yeast overgrowth) to somewhat control the symptoms. When things got really bad I would take an nasty antifungal called Ketoconazole ...wouldn't recommend it since it can damage the liver, just what we don't need! There may be other options out there at this point, I don't know, but would be interested in knowing if anyone else does. I do know it's something that I also had a hard time getting tested for as a chronic problem, but it's very real. Oddly, even though my PSC is pretty bad now, I rarely have flare-ups of thrush, but my lifestyle and diet is very different now than it was way back when.

Jeff in FL

PSC 1989

Hi ,I read your post and wanted to know: do you think there are certain anti-biotics/anti-fungals that are better than others? Is there any way to diagnose candida infection that you're aware of? I've been telling a bunch of docs I might have candida but haven't gotten much of a response from them. One, an allergist, even specifically refused to test me for it. Thanks,Jarad

[Guest guest]

Jarad, and anyone else interested in the Candida issue. When I was first diagnosed with PSC 20 years ago and in desperate shape (my primary bile duct had been almost totally blocked with a dominant stricture for who knows how long) I had terrible problems with yeast overgrowth in the mouth and on the tongue for about two years prior to being opened up and stented with a T-tube. Candida in the mouth (thrush) is pretty easily recognizable and usually looks like the tongue is white and furry sometimes with scattered red patches, sometimes not. Often the tongue will be sore as well. Also, the overgrowth can show up in the mucous membranes of your mouth and your gums. To the tongue, it will feel like the skin inside your mouth is slightly bumpy and sometimes like it's peeling off. Once the stent was placed in my primary duct (at that time I only had a few strictures, now you can't count them!), these symptoms cleared within a week! But through the course of 2 years prior to that I used plain Nystatin powder, probiotics, and diet (simple sugars are the worst for yeast overgrowth) to somewhat control the symptoms. When things got really bad I would take an nasty antifungal called Ketoconazole ...wouldn't recommend it since it can damage the liver, just what we don't need! There may be other options out there at this point, I don't know, but would be interested in knowing if anyone else does. I do know it's something that I also had a hard time getting tested for as a chronic problem, but it's very real. Oddly, even though my PSC is pretty bad now, I rarely have flare-ups of thrush, but my lifestyle and diet is very different now than it was way back when.

Jeff in FL

PSC 1989

Hi ,I read your post and wanted to know: do you think there are certain anti-biotics/anti-fungals that are better than others? Is there any way to diagnose candida infection that you're aware of? I've been telling a bunch of docs I might have candida but haven't gotten much of a response from them. One, an allergist, even specifically refused to test me for it. Thanks,Jarad

[Guest guest]

Jarad, and anyone else interested in the Candida issue. When I was first diagnosed with PSC 20 years ago and in desperate shape (my primary bile duct had been almost totally blocked with a dominant stricture for who knows how long) I had terrible problems with yeast overgrowth in the mouth and on the tongue for about two years prior to being opened up and stented with a T-tube. Candida in the mouth (thrush) is pretty easily recognizable and usually looks like the tongue is white and furry sometimes with scattered red patches, sometimes not. Often the tongue will be sore as well. Also, the overgrowth can show up in the mucous membranes of your mouth and your gums. To the tongue, it will feel like the skin inside your mouth is slightly bumpy and sometimes like it's peeling off. Once the stent was placed in my primary duct (at that time I only had a few strictures, now you can't count them!), these symptoms cleared within a week! But through the course of 2 years prior to that I used plain Nystatin powder, probiotics, and diet (simple sugars are the worst for yeast overgrowth) to somewhat control the symptoms. When things got really bad I would take an nasty antifungal called Ketoconazole ...wouldn't recommend it since it can damage the liver, just what we don't need! There may be other options out there at this point, I don't know, but would be interested in knowing if anyone else does. I do know it's something that I also had a hard time getting tested for as a chronic problem, but it's very real. Oddly, even though my PSC is pretty bad now, I rarely have flare-ups of thrush, but my lifestyle and diet is very different now than it was way back when.

Jeff in FL

PSC 1989

Hi ,I read your post and wanted to know: do you think there are certain anti-biotics/anti-fungals that are better than others? Is there any way to diagnose candida infection that you're aware of? I've been telling a bunch of docs I might have candida but haven't gotten much of a response from them. One, an allergist, even specifically refused to test me for it. Thanks,Jarad

[Guest guest]

Very interesting! I think they're getting warmer about what is

causing PSC!

>

> Dear All;

>

> I thought that this article would be of potential interest to

those

> suffering from persistent cholangitis. Whereas bacterial

infections

> are the most common cause, this report shows that fungal

infections

> with Candida species can also occur in PSC:

> __________________________

>

> J. Hepatol. [in Press] (2006)

>

> Biliary Candida infections in primary sclerosing cholangitis.

>

> Hasan Kulaksiz, Gerda Rudolph, Petra Kloeters-Plachky,

Sauer,

> Heinrich Geiss, Adolf Stiehl

>

> Received 6 June 2006; received in revised form 4 July 2006;

accepted

> 13 July 2006 published online 10 August 2006.

>

> Uncorrected Proof

>

> Abstract

>

> Background/Aims

> Patients with Primary Sclerosing Cholangitis (PSC) frequently

> develop dominant stenoses of the bile ducts and bacterial

infections

> represent a major problem in such patients. In the present study,

> the role of fungal infections of the bile ducts has been evaluated.

>

> Methods

> In a prospective non-randomized trial, in 67 consecutive patients

> with PSC, 148 bile samples, each taken at one endoscopic

> examination, were microbiologically analysed.

>

> Results

> Candida species were found in 8/67 patients whereas Aspergillus

was

> not detected. Seven patients with biliary Candida had a dominant

> stenosis and one had a wide papillotomy with chronic ascending

> cholangitis. Altogether 7/49 of patients with dominant stenosis

and

> 1/18 of patients without dominant stenosis had Candida in their

> bile. All patients with biliary Candida intermittently had

received

> antibiotics and had advanced disease with cholestasis. Candida

> disappeared spontaneously in 2/7 patients, cleared after

antifungal

> treatment in 2, and persisted in 3 patients. Patients with biliary

> Candida had more severe cholangitis with higher CRP and serum

> bilirubin compared to those without Candida infection.

>

> Conclusions

> This is the first report on the identification of Candida species

in

> the bile of patients with PSC. Apart from bacterial also fungal

> infection of the bile ducts should be considered in the treatment

of

> such patients.

>

> Keywords: Sclerosing cholangitis, Candida infection, Biliary

> disease, Cholestasis, Liver disease, Ursodeoxycholic acid

>

> Department of Medicine, University of Heidelberg, Medizinische

> Universitätsklink, Im Neuenheimer Feld

>

> 410, D-69120 Heidelberg, FRG, Germany

>

> Corresponding author. Tel.: +49 6221 568707; fax: +49 6221 565687.

>

> PII: S0168-8278(06)00410-7

>

> doi:10.1016/j.jhep.2006.07.022

> __________________________

>

> Best regards,

>

> Dave

> (father of (21); PSC 07/03; UC 08/03)

>

[Guest guest]

Very interesting! I think they're getting warmer about what is

causing PSC!

>

> Dear All;

>

> I thought that this article would be of potential interest to

those

> suffering from persistent cholangitis. Whereas bacterial

infections

> are the most common cause, this report shows that fungal

infections

> with Candida species can also occur in PSC:

> __________________________

>

> J. Hepatol. [in Press] (2006)

>

> Biliary Candida infections in primary sclerosing cholangitis.

>

> Hasan Kulaksiz, Gerda Rudolph, Petra Kloeters-Plachky,

Sauer,

> Heinrich Geiss, Adolf Stiehl

>

> Received 6 June 2006; received in revised form 4 July 2006;

accepted

> 13 July 2006 published online 10 August 2006.

>

> Uncorrected Proof

>

> Abstract

>

> Background/Aims

> Patients with Primary Sclerosing Cholangitis (PSC) frequently

> develop dominant stenoses of the bile ducts and bacterial

infections

> represent a major problem in such patients. In the present study,

> the role of fungal infections of the bile ducts has been evaluated.

>

> Methods

> In a prospective non-randomized trial, in 67 consecutive patients

> with PSC, 148 bile samples, each taken at one endoscopic

> examination, were microbiologically analysed.

>

> Results

> Candida species were found in 8/67 patients whereas Aspergillus

was

> not detected. Seven patients with biliary Candida had a dominant

> stenosis and one had a wide papillotomy with chronic ascending

> cholangitis. Altogether 7/49 of patients with dominant stenosis

and

> 1/18 of patients without dominant stenosis had Candida in their

> bile. All patients with biliary Candida intermittently had

received

> antibiotics and had advanced disease with cholestasis. Candida

> disappeared spontaneously in 2/7 patients, cleared after

antifungal

> treatment in 2, and persisted in 3 patients. Patients with biliary

> Candida had more severe cholangitis with higher CRP and serum

> bilirubin compared to those without Candida infection.

>

> Conclusions

> This is the first report on the identification of Candida species

in

> the bile of patients with PSC. Apart from bacterial also fungal

> infection of the bile ducts should be considered in the treatment

of

> such patients.

>

> Keywords: Sclerosing cholangitis, Candida infection, Biliary

> disease, Cholestasis, Liver disease, Ursodeoxycholic acid

>

> Department of Medicine, University of Heidelberg, Medizinische

> Universitätsklink, Im Neuenheimer Feld

>

> 410, D-69120 Heidelberg, FRG, Germany

>

> Corresponding author. Tel.: +49 6221 568707; fax: +49 6221 565687.

>

> PII: S0168-8278(06)00410-7

>

> doi:10.1016/j.jhep.2006.07.022

> __________________________

>

> Best regards,

>

> Dave

> (father of (21); PSC 07/03; UC 08/03)

>

[Guest guest]

Very interesting! I think they're getting warmer about what is

causing PSC!

>

> Dear All;

>

> I thought that this article would be of potential interest to

those

> suffering from persistent cholangitis. Whereas bacterial

infections

> are the most common cause, this report shows that fungal

infections

> with Candida species can also occur in PSC:

> __________________________

>

> J. Hepatol. [in Press] (2006)

>

> Biliary Candida infections in primary sclerosing cholangitis.

>

> Hasan Kulaksiz, Gerda Rudolph, Petra Kloeters-Plachky,

Sauer,

> Heinrich Geiss, Adolf Stiehl

>

> Received 6 June 2006; received in revised form 4 July 2006;

accepted

> 13 July 2006 published online 10 August 2006.

>

> Uncorrected Proof

>

> Abstract

>

> Background/Aims

> Patients with Primary Sclerosing Cholangitis (PSC) frequently

> develop dominant stenoses of the bile ducts and bacterial

infections

> represent a major problem in such patients. In the present study,

> the role of fungal infections of the bile ducts has been evaluated.

>

> Methods

> In a prospective non-randomized trial, in 67 consecutive patients

> with PSC, 148 bile samples, each taken at one endoscopic

> examination, were microbiologically analysed.

>

> Results

> Candida species were found in 8/67 patients whereas Aspergillus

was

> not detected. Seven patients with biliary Candida had a dominant

> stenosis and one had a wide papillotomy with chronic ascending

> cholangitis. Altogether 7/49 of patients with dominant stenosis

and

> 1/18 of patients without dominant stenosis had Candida in their

> bile. All patients with biliary Candida intermittently had

received

> antibiotics and had advanced disease with cholestasis. Candida

> disappeared spontaneously in 2/7 patients, cleared after

antifungal

> treatment in 2, and persisted in 3 patients. Patients with biliary

> Candida had more severe cholangitis with higher CRP and serum

> bilirubin compared to those without Candida infection.

>

> Conclusions

> This is the first report on the identification of Candida species

in

> the bile of patients with PSC. Apart from bacterial also fungal

> infection of the bile ducts should be considered in the treatment

of

> such patients.

>

> Keywords: Sclerosing cholangitis, Candida infection, Biliary

> disease, Cholestasis, Liver disease, Ursodeoxycholic acid

>

> Department of Medicine, University of Heidelberg, Medizinische

> Universitätsklink, Im Neuenheimer Feld

>

> 410, D-69120 Heidelberg, FRG, Germany

>

> Corresponding author. Tel.: +49 6221 568707; fax: +49 6221 565687.

>

> PII: S0168-8278(06)00410-7

>

> doi:10.1016/j.jhep.2006.07.022

> __________________________

>

> Best regards,

>

> Dave

> (father of (21); PSC 07/03; UC 08/03)

>

[Guest guest]

Hi ,

I read your post and wanted to know: do you think there are certain

anti-biotics/anti-fungals that are better than others? Is there any

way to diagnose candida infection that you're aware of? I've been

telling a bunch of docs I might have candida but haven't gotten much

of a response from them. One, an allergist, even specifically

refused to test me for it. Thanks,

Jarad

-- In , MO425@... wrote:

>

> ,

> My doc gave me Flagyl a couple of times, along with Levaquin for a

> cholangitis infection...maybe this is why. Many years ago I had

some serious issues as

> a result of candida, and was forced to change my diet...really my

whole

> lifestyle. I was told during this last inpatient stay, that the

Neomycin I take for

> H.E. clears the flora out INSTANTLY. Also, with the additional

antibiotics

> (Levaquin, Augmentin, and Rifampin) I'm candida's dream. So, the

ER and the

> in-house doc told me I should get better probiotics than the ones

I am taking

> and I was recommended Primal Defense. I had a friend pick me up

some yesterday

> and took my first dose last night. I'm planning to show

improvement in my

> overall health soon...according to them I will notice a change for

the better

> pretty quick. I know this won't cure me, but any improvement is

always exciting.

>

> Thanks for posting this article.

>

> (MO)

> PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05

> for details see www.caringbridge.org/visit/melaniejs

>

[Guest guest]

Hi ,

I read your post and wanted to know: do you think there are certain

anti-biotics/anti-fungals that are better than others? Is there any

way to diagnose candida infection that you're aware of? I've been

telling a bunch of docs I might have candida but haven't gotten much

of a response from them. One, an allergist, even specifically

refused to test me for it. Thanks,

Jarad

-- In , MO425@... wrote:

>

> ,

> My doc gave me Flagyl a couple of times, along with Levaquin for a

> cholangitis infection...maybe this is why. Many years ago I had

some serious issues as

> a result of candida, and was forced to change my diet...really my

whole

> lifestyle. I was told during this last inpatient stay, that the

Neomycin I take for

> H.E. clears the flora out INSTANTLY. Also, with the additional

antibiotics

> (Levaquin, Augmentin, and Rifampin) I'm candida's dream. So, the

ER and the

> in-house doc told me I should get better probiotics than the ones

I am taking

> and I was recommended Primal Defense. I had a friend pick me up

some yesterday

> and took my first dose last night. I'm planning to show

improvement in my

> overall health soon...according to them I will notice a change for

the better

> pretty quick. I know this won't cure me, but any improvement is

always exciting.

>

> Thanks for posting this article.

>

> (MO)

> PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05

> for details see www.caringbridge.org/visit/melaniejs

>

[Guest guest]

Hi ,

I read your post and wanted to know: do you think there are certain

anti-biotics/anti-fungals that are better than others? Is there any

way to diagnose candida infection that you're aware of? I've been

telling a bunch of docs I might have candida but haven't gotten much

of a response from them. One, an allergist, even specifically

refused to test me for it. Thanks,

Jarad

-- In , MO425@... wrote:

>

> ,

> My doc gave me Flagyl a couple of times, along with Levaquin for a

> cholangitis infection...maybe this is why. Many years ago I had

some serious issues as

> a result of candida, and was forced to change my diet...really my

whole

> lifestyle. I was told during this last inpatient stay, that the

Neomycin I take for

> H.E. clears the flora out INSTANTLY. Also, with the additional

antibiotics

> (Levaquin, Augmentin, and Rifampin) I'm candida's dream. So, the

ER and the

> in-house doc told me I should get better probiotics than the ones

I am taking

> and I was recommended Primal Defense. I had a friend pick me up

some yesterday

> and took my first dose last night. I'm planning to show

improvement in my

> overall health soon...according to them I will notice a change for

the better

> pretty quick. I know this won't cure me, but any improvement is

always exciting.

>

> Thanks for posting this article.

>

> (MO)

> PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05

> for details see www.caringbridge.org/visit/melaniejs

>

[Guest guest]

With the present discussion, I wanted to add one more thing.

I'm definitely a " student " in PSC/CC so bear with me, but I think

there's a difference between having blood-borne candida and what we

all know as " yeast infections. " The doctors continually monitored

Brad for infection of any kind. They called for very specific tests

on the blood. When candida was detected in the blood, he was

immediately admitted to the hospital for 3-day IV antibiotic therapy.

When he was released, he continued taking antibiotics (fluconazole)

for 3 weeks. So far, so good.

Diane

[Guest guest]

With the present discussion, I wanted to add one more thing.

I'm definitely a " student " in PSC/CC so bear with me, but I think

there's a difference between having blood-borne candida and what we

all know as " yeast infections. " The doctors continually monitored

Brad for infection of any kind. They called for very specific tests

on the blood. When candida was detected in the blood, he was

immediately admitted to the hospital for 3-day IV antibiotic therapy.

When he was released, he continued taking antibiotics (fluconazole)

for 3 weeks. So far, so good.

Diane