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Ask DrRussMD Your Own Question
DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 64628
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
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I have been struggling with chronic Sinus infections and

Customer Question

I have been struggling with chronic Sinus infections and Fungus for 15 Mths plus Surgery in the past. I now have SCEDOSPORIUM-APIOSPERMUM AND BETA HEMOLYTIC STREPTOCCUS and OROPHARYNGEAL FLORA. Can you tell me the symptoms and also how dangerous they can be?
Submitted: 1 year ago.
Category: Medical
Expert:  TheGermDoctor replied 1 year ago.

What symptoms do you have?

When was your last CT and what did it show?

When did you have surgery? what did they do?

Customer: replied 1 year ago.
Thank you But my ENT is on top of it. I was just trying to get some info on the New Stuff.and the Meds they have me on now,
Thanks anyway.
Expert:  TheGermDoctor replied 1 year ago.

OK... I won'y ask about your ENT issues- and will leave that to him

so please clarify what specifically you would like me to answer about your cultures or antibiotics?

( I am an infectious diseases specialist by the way)

Customer: replied 1 year ago.
I just wanted to learn more about the ones I have now,The Symptoms that go along with them, A How Dangerous they can be, Thanks But It sounds like it might be easier to try to look it up.I dont want to pay to talk on the phone, and im not sure for $35 i will learn anything new,
Customer: replied 1 year ago.
oh oops and if the meds they started me on intill they get all the results back from the cultures sound like good optopons.
Customer: replied 1 year ago.
Hi again but did you not receive the things I have an the meds they have me on?
Expert:  TheGermDoctor replied 1 year ago.

Sorry I was away for a while

There is no answer to what "symptoms" those particular organisms cause-One is a fungus, the other a bacteria. IN some people they can cause sinusitis- with pain, chronic cough, headaches, chronic discharge/ nasal drip; whereas in other it can be completely asymptomatic- By that I mean the exact same organisms can colonize the surface of sinuses and cause no symptoms at all. That is why one cannot answer your questions without knowing all the relevant ENT details. There is an entire spectrum from none to severe symptoms that may or may not be related.

As for your medications, you are on an antifungal ( itraconazole), an antibiotic ( moxifloxacin) and a steroid - each has their own possible side effects- and quite a few in fact.

Itraconazole has lots of drug interactions, can cause rash and most commonly as a side effect causes liver abnormalities.

Moxi- can occasionally affect heart rhythms, rarely injures tendons, or causes eye trouple, and rarely causes certain neurologic conditions- But having said that the vast majority have no side effects

Prednisone is a steroid- most people feel better on it- but it has lots of side effects- elevated blood sugar, affecting bones, sometimes affecting mood, weight gain and others

I hope that helps some

Please provide a rating that I did answer your questions,( within the limitations you asked for)

Customer: replied 1 year ago.
If I send pictures of the yucky stuff the dr got out? Or pictures of the stuff I am getting out with my Neil Med rinses? As to what meds they put me on I don't feel like you answered if they would help with all the sinus pain and pressure headaches and green infection that I am getting out.
Expert:  TheGermDoctor replied 1 year ago.

No need to send pictures - I will take for granted that you have discharge

As for if the medications will work- impossible to say- again without knowing what your CT looks like, what your sinuses look like, what your last nasal endoscopy showed. There are variables related to your immune system, nutrition, anatomy and many other factors.

The "right" antibiotics may work in some people and not in others for a whole variety of reasons.

Based on your cultures are these antibiotics reasonable? Sure-

How they will work is something that you and your doctor will determine based on how you respond.

Please provide a rating for my answer

Customer: replied 1 year ago.
Hello Germ Dr. When I signed up to pay the 34,99 they said to pay the five dollars and if I was satisfied with the answer I would be charged additional 29. Even though you tried I do not feel like you gave me the answers I was asking at all. I was hoping to get some answers of what the things I have are and symptoms and also if the medication I am on would help me out while I was waiting for an appointment on Monday morning. I know you said you are a Germ Dr I have an appointment with one of those too. And like you said you would need cultures history surgeries MRIs all of that that my doctor has. So I feel like I would pay the five dollars but I do not feel like you answered the questions that would help stop my worries until I go to my Doctors. Thank you anyway
Expert:  DrRussMD replied 1 year ago.


I am a double board certified clinical doctor, and one of the few with this in the country.

What questions remain for you

Customer: replied 1 year ago.
Ok I will try one more time. What is Oropharyngeal flora?
And does the Anbiotic they have me on Moxifloxacin cover both
Customer: replied 1 year ago.
Ok I will try one more time. What is Oropharyngeal flora?
And does the Anbiotic they have me on Moxifloxacin cover both
BETA HEMOLYTIC STREPTOCCUS And OROPHARYNGEAL FLORA?Ok I will try one more time. What is Oropharyngeal flora?
And does the Anbiotic they have me on Moxifloxacin cover both
Expert:  DrRussMD replied 1 year ago.

Oropharyngeal flora: This is the normal bacteria that is in the mouth and throat.

We have bacteria that live with use throughout our digestive track. Mouth, throat, esophagus, stomach, intestines.

You do not treat oropahryneal flora. You treat strep. You want the normal oropharyngeal flora to service.

The antibiotic will kill some of them, but you don't want that.

You want to kill the strep.

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here