Detection of fungi in the throat swab

Question

Dear expert team,
our daughter suffers from CF and is now nearly 5 years old. She is doing well and the doctors are very content. The last throat swab detected now Aspergillus and Candida. Looking in the past, she has otherwise mostly Staph. aureus in the swab.
As she is doing well, we do not have to do anything concerning this result.
What would you recommend?
Should we, if necessary, nevertheless start a therapy?
Where could she have the germ from?
What effect do the fungi have?
Many thanks for your answer.

Answer

Dear parents,
the finding of a fungus in the throat swab is not uncommon. In general, there are no clinical complaints and symptoms going along with it. The reason is in general the frequent and necessary use of antibiotics. One would never initiate an anti-mycotic therapy because of this finding of fungi.
In case a long-term antibiotic treatment systemically or orally should become necessary in the later adolescence or at adult age, then one would see primarily in case of a finding of fungi, in how far these fungi are responsable for clinical symptoms. Only then a therapy will be discussed.
As your child is doing well at the moment, you do not have to initiate any therapeutical measures. In case of recurrent findings of fungi in the throat swab, one can stay relaxed. It is always good, to discuss such findings with the CF Center staff.
The finding of fungi is not a sign of an aquired additional infection. It deals only with an impairment of the balance between bacteria and fungi.
The fungi are not going to cause health damage in the lung.
If no antibiotics are given for a longer period of time, one is not going to find fungi in the throat swab, either.

Best regards,
Dr. H.-E. Heuer

13.10.2014