Cyclosporine and fungal infections

[Hopeful]

Hi,

Does anyone know if just being on Cyclosporine increases your risk of fungal infections from hay/dirt/wood spores? I have a low white blood cell count but low-normal ANC. Am I at a higher risk of a fungal infection than the general population because I am on Cyclosporine?

[Ruth Cuadra]

Yes, Hopeful. While you are taking cyclosporine, which in an immunosuppressant, you are at higher risk for any sort of infection--bacterial, viral, or fungal. Fungal infections can be very difficult to treat so I would avoid possible contaminants, including hay, dirt, and wood. Immunosuppressed patients are generally discouraged from gardening for this reason.

Regards,
Ruth

[Marlene]

Even though John was not on cyclo, he didn't do any yard work for at least three years after treatment. And then when he would help rake leaves in the fall, he wore his mask...the thick one at that. The amount of molds in the soil can be quite high.

[Gloria J]

After I had my ATG treatment, I took an anti-viral med for three months. I did not eat anything that was not cooked for almost two years, I was that spooked about food poisoning. I was not cleared for gardening work until my ANC hit 1.5. Even having fresh flowers in the house (after ATG) was not allowed. I was warned about fungal and mold problems from the soil also. Although, it did seem to be okay to keep existing house plants around (I'm guessing because I had always been around them).

Not being able to garden last summer was tough - I ended up hiring a college student to do my weeding and planting, and enjoyed the fruit of her labors. This summer, I've been out there myself, but always with heavy gardening gloves on.

Another good reason to keep track of your counts, especially the WBC and ANC. Sometimes it's not easy with all of the restrictions imposed by an immunosuppressant regime, but the alternative (having to fight off an infection with less-than-impressive white cell counts) definitely makes it easy for me to say 'no' to a lot.

[Lisa V]

Gloria, I'd say it's more important to look at your ANC and your patterns of response in general when making this determination. Also what your cyclo dosage is.

I say this because we have a plant nursery/farm (we live on the property too), and if my husband had avoided work post-ATG I don't know what we'd do! He did take a few weeks off following the first round, but after round 2 he went back to work immediately after coming home from the hospital. Fortunately for him, he has never been severely neutropenic, but he has been on CsA maintenance for the last 5 years, and (because of his trisomy 8) may have to continue it indefinitely. Presumably for this reason, his WBCs have never quite returned to normal, currently averaging 3.6. His ANC is currently in the 2.1-2.4 range, so his doctor is not concerned, but even when it was around 1.0 he was out there digging in the dirt and being exposed to every kind of mold and bacteria and he didn't have any problems with it.

Mind you, I'm not recommending this for everyone, just saying that everyone has a different tolerance level, and just because you are or were on immune suppressants doesn't necessarily mean you should have to avoid gardening. Better to be on the safe side, but there's no way I could have kept Ken from doing what he loves, and the fact that it's our income was obviously added incentive. We're just lucky that he didn't develop any kind of infection.