Fungus. Can this spread? Has anyone had this problem?

Her problems has multiple causes:
1 - warm, moist, dark environment encourages growth of yeast and fungus
2 - her immune system is probably not in great shape
3 - she won't let others clean her often enough

Things that can help:
1 - Let her sleep without a diaper (absorbent pad underneath and on top) so her skin can dry out a bit
2 - Nystatin powder or cream applied to the rash with every diaper change and bath
3 - Anti-fungal oral medication
4 - if able, install a bidet attachment to her toilet so she gets "cleaned" every time she uses the bathroom
5 - Try to eliminate sugar and refined carbohydrates from her diet that may be "feeding the fungus"

Fungal infections are a beast as they are persistent. It’s hard enough doing successful treatment with a cooperative family member. Add a patient with dementia and it’s really hard to consistently treat the area and keep it dry or let it air.

if They haven’t run a culture on it yet, it needs to be done. There’s a lot of fungus….. and some are resistant to some medications.

There are a newer line of medications for fungal and bacterial infections that ime seem to work where all other have failed. But $$$. Specifically Crown Lab’s Ala-Quin, hydrocortisone .5% Iodochlorhydroxyquin 3%. It’s a cream, runs abt $450-$600 for 80 gram tube. Most pharmacy plans won’t cover it at all even with 80% copay as there’s a ton of other fungal meds available & all that have to be tried first. No generic. If you have a friendly dermatologist ask for a couple of sample tubes & see if the medical director will let the samples be tried on her. It’s amazing stuff. The hydro is a steroid so it deals with lessening the itching and redness and the iodo is a targeted antibiotic.

Make sure it’s ALA-Quin (Crown Laboratories) NDC 0316-0123-80.

Not ALO-Quin or Alcortin A, these are even more $$$$$ specialty Derm drugs. I’ve seen these 2 priced at $ 9,000 per tube. Crazy.

if the culture should show its tinea, theres a newer drug for it too. Luzu, Luliconazole cream 1%, Valeant Laboratories. It’s been out for a while so it has a generic that runs abt $100 & the regular runs $250/300.

They should reculture this. Fungal infections treated with the proper medication will clear, but often the absence of the fungal problem can open to infection with bacteria. Given that there is fecal contamination and the area is often not "open to the air" it is difficult to heal. Just talked about this on another question earlier. It can be a merry go round of fungal infection, bacterial, fungal, bacterial, and without wound culturing it is difficult to tell what is going on. This can come down to good wound care treatment and followup. It can leave someone looking like a piece of raw meat and be severely painful. I am sorry and wish you good luck.

Murphy there are systemic treatments (i.e. tablets rather than creams or ointments) for fungal infections too, but it may be that your mother isn't well enough for these to be justifiable (they can be rough on kidneys and liver, from memory). Still, it can't hurt to ask her doctor, can it?

Fungal infections like damp warm places. Very difficult to avoid those in a person who is incontinent and wears protection.

30 years ago I ended up with fungus 2 years in a row. 1st time was mostly limited to my arms and legs. The next year I got the fungus again this time it spread from arms and legs to the trunk of my body (but not to my bum). It took over a month to get rid of the infection. Don't know why I got fungus or where. I was allergic to sulfa and took another antifungal pill and I think I also had a Rx cream to apply.

I am only 70 and is otherwise good health. Last September, when I had my annual physical, I showed my doctor a yeast infection under my breasts that I'd had since August but hadn't been able to get rid of with cream Nystatin, which I keep on hand( I had had 3 very mild bouts years before, and the cream always worked). This time, she said the area was "too wet" (full of the serum your body makes in serious cases) to use cream at that point, so I am now on my eighth month of Nystatin powder and cream, plus the yeast infection spread all the way up to my chin, overlaid by horrible contact dermatitis. I had body-wracking fever and chills, often together, and sleepless nights, when the pain was so bad I couldn't find a comfortable sleeping position. I am hoping the last of both will go soon, especially since I am overdue for my annual mammogram and until recently, I couldn't have stood the pain of anyone touching my breasts. I was also given fluconazole at one point, which helped some but did not eliminate the yeast infection. Currently, I have the stubborn remnant between my breasts and a bit on my abdomen. The residual of the dermatitis is still visible, although no longer painful, and it is slowly going away. I had never had contact dermatitis in my life, and from what my doctors and I can tell, I had so much Nystatin, it got in my system - I could taste it!- eeyuk!!! -and my body reacted to it as an allergen. All of this is told to emphasize NOT to be stupid as I was and put off going to the doctor, just because you have an appointment soon or think you know how to handle a more serious version of an old problem. You CAN get sepsis if the yeast goes deeply enough - mine must have gotten into my system, because I had 4 cut-like marks that were open under my left breast, and when I applied Nystatin powder, it stung so badly, I could hardly stand it for up to half an hour. This gradually subsided and went away, but I will never take this lightly again. Unfortunately, once you have it, it seems easier to get it back. Take very good and careful care. She is lucky she has someone like you helping her.

It's most likely candida. Bottom line is she isn't being kept dry, but if she is resistant to care that's going to be difficult.

https://www.healthline.com/health/adult-diaper-rash

Invasive Candidiasis?
Global Emergence of Candida auris
Candida auris is an emerging multidrug-resistant type of Candida that presents a serious global health threat, including in the United States. It can cause severe infections and spreads easily in healthcare facilities.

Invasive candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Unlike Candida infections in the mouth and throat (also called “thrush”) or vaginal “yeast infections,” invasive candidiasis is a serious infection that can affect the blood, heart, brain, eyes, bones, and other parts of the body. Candidemia, a bloodstream infection with Candida, is a common infection in hospitalized patients.

My 90 year old mother had a severe yeast infection under her breasts for a year. It also started to spread. After her shower I would use a hair dryer on low heat under her breast to dry the area. I also purchased men’s white - Cotton -old fashioned handkerchiefs and rolled them up placing under her breasts to absorb the wetness. Changing when it became damp. Nystatin didn’t work for Mom. Aloe vista anti fungal and zinc oxide was our routine that cleared the problem up. Couldn’t find the aloe vista anti fungal local but ordered from the internet. The zinc oxide I used during night time as a barrier while sleeping.
we also cut back her sugar intake and added kefir to her diet daily. Good luck.

Murphy18966: I do not profess to be a physician, but your mother may have to switch over to an oral medication so that at least she is receiving some form of medication, in lieu of it being wiped off onto bedding or feminine pads via a cream of ointment.