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Fungal Asthma / Fungal Sinusitis / Tinea Capitis
Fungal Disease Expert Requested
Tinea capitis started in February 2014 after a brief visit to Florida. Primary symptom, itchy scalp. Also flaking if gets bad. Dermatologist prescribed Nizoral shampoo, no effect. Tried a long list of topical treatments detailed below, all to no effect.

Meanwhile, it got into my sinuses. Symptom: "smoky" sensation.
Then I started having trouble with speaking - change in pitch and difficulty vocalizing.
Then I started having asthma symptoms, after having been in remission from asthma for over a decade.

I started itraconazole 9/4/2014 and it abolished my asthma symptoms until the past couple of weeks. I had a compounding pharmacist make up an itraconazole nasal spray 11/20/14 and it abolished my sinus symptoms until recently, but now I am starting to have the "smoky" sensation again. I also had the compounding pharmacist make up an itraconazole lotion for my scalp which helped somewhat for a while.

It is a serious situation at this point because an albuterol inhaler is insufficient and I have had asthma attacks twice requiring prednisone to control.

Prior to starting the itraconazole in September I tried the following medications which had no effect: terbinafine, fluconazole.
I also tried griseofulvin but was unable to tolerate it due to aggravation of pre-existing tinnitus.

Topical treatments to scalp that had limited or no effect:
Nizoral/ketoconazole, Zinc (Head & Shoulders) , Miconazole shampoo, Ciclopirox shampoo, Selenium (Selsun Blue), Clotrimazole lotion, Neem shampoo, various essential oils including tea tree. Clove leaf oil helps somewhat.

No attempt has been made to culture the pathogen.

Possible Predisposing Condition / Risk Factor
Extensive use of antibiotics due to chronic bacterial prostatitis, from 2001 until 2013, when antibiotics ceased being effective. (Had a radical TURP, 2013, which helped somewhat) Suspect the antibiotic usage harmed my skin flora and left me vulnerable to fungal infection.

Personal Data:
Male, age 64, height 5'6", weight 150 lbs, blood pressure typically around 120/80
Exercise daily
In long term relationship but living separately at this time
Retired engineer, trade stocks for income
Reside in small community 2-4 hour drive from specialist care

Category: Family Physician-GP

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Dr. Jaydeep Tripathy
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MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
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