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Hi, wondering if anyone can advise what this infection might be (bacterial /fungal).

My firemouth has been looking like he is gasping for a few weeks now and just mostly lethargic and not eating.
He is the only fish I have in a 60lr tank and I think he is around 8 years old. I have a Eheim pickup 160 filter.

At first when I noticed this behaviour he was sitting at the bottom of the tank looking like he was gasping. I did a water change 25% that day and increased aeration. unfortunately I forgot to test water prior to the first change however 30 mins after I tested and the the nitrates were high, around 20 and ammonia was somewhere between 0 and 0.25 (hard to tell with testing kit) so I did another 25% change. 2 days after that I a small water change to clean the filter which hadn't been cleaned in a while.
After this first he moved from the bottom of the tank to sitting just below the surface next to the heater and increasing aeration didn't seem to help him.

I have did a few more 25% water changes since then and the water levels are now seem ok I think:
Ammonia I think is 0, again hard to tell with the testing kit but it definitely looks more yellow than green.
Nitrite 0
Nitrate 5
ph 6.8
Temp 26degrees Celsius

there has been no improvement after water changes /aeration and he is back to sitting at the bottom of the tank. Then 4 days ago I noticed this white spot near his gills. I have been treating with Melafix although about half the recommended dose as I am worried about bad reports using this. No improvement yet.

I have ordered some aquarium salt and tri- Sulfa tablets online (local pet shops closed during lockdown) but they will take up to a week to arrive.

Also I'm not sure but he sort of looks bloated on his left side near the top fins compared to the other side.
 

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You have an old Firemouth Cichlid. His immune system isn't as sharp as it used to be. And so as this fish ages out, things in his aquarium and water that he used to tolerate or live with, will begin to affect him.
Treating with the salt won't heal this Cichlid, but it will be supportive in his care. Your Melafix is a something to try that may work. Maracyn is another medication you could look into that will treat fungal infections in fish.
Keep up those water changes to drive those Nitrates down as closer to zero as possible, and maintain salt addition for the water during your treatment regimen.
Preventive measures that will help to boost his immune system and (hopefully) keep these things from happening include,
- Provide multiple sources of pelleted, staple food.
- Keep pellet food refrigerated to maintain freshness and nutritional values.
- Feed with 'treat' foods once or even twice weekly. Chopped earthworms, pealed raw shrimp pieces, chopped pieces of menhaden, black worms etc...
- Conduct thorough cleaning of all filtration media with tank water at least once per month.
- Regular water changes! Maintain those Nitrates down below a measured 20 PPM in the water of his aquarium.
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Good luck with it. Looks like you've got a pretty nice 'wet pet', and those kinds of fish can be pretty special. I hope he gets better for you! :)
 
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