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Travel Medicine (Expert Forum)
Post-Viral Infection
Answered by
Philip Parks, MD - Occupational Safety, Occupational Health, Travel Medicine, Environmental Health
Harvard School of Public Health
Boston - MA
Questions in the Travel Medicine forum are answered by Dr. Philip D Parks, affiliated with Harvard School of Public Health. Topics covered include disease prevention, finding a doctor abroad, food and water safety, illness and injury abroad, mosquito and tick protection, resources for travelers, traveling with children or pets, traveling with special needs, vaccinations and immunizations.
Post-Viral Infection
by Cait125, Feb 13, 2008 11:25PM
For the last 3 months I have been having severe joint paint, fatigue, low grade fever, back and neck pain and skin rashes. I spent 4 months in Ghana and another 4 in Tanzania prior to this illness. I have seen many doctors who have concluded that it may be the beginnings of an autoimmune disease or a post-viral infection. I am looking to get some more information on either if these diagnoses or on other possible reasons for the illness, parastic?
Thank you!
Thank you!
Doctor's Answer
I just returned from the dr.s and was told I have blastocystis but could this be causing the other symptoms? I am going to see an I.D. doctor next week since this dr did not know much about the parasite. She did not prescribe any treatment yet.
Thanks
I am reassured that you will be seeing an Infectious Disease physician next week who will be able to comprehensively review your medical, travel, occupational, and domestic history.
Where do you live now? Have tick borne illnesses been ruled out?
Has malaria been ruled out?
What diagnostic work-up has been completed and what were the results?
Blood tests, imaging, lumbar puncture, etc..?
What were you doing in Ghana and Tanzania? Did you take malaria prophylaxis (or was it recommended? If so, what medication? If so, did you take the medication consistently?
I would agree that blastocystis may not be all of the story here.
Please keep your questions and comments coming.
Link to information from the CDC on blastocystis: http://www.cdc.gov/NCIDOD/DPD/PARASITES/blastocystishominis/factsht_blastocystis_hominis.htm
~*~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
When I was away, I did have malaria twice that I know of and was sick another time but was unable to seek medical attention. I was working on a research project in both countries. I was taking a prophylaxis and tried to be mindful of the daily pill. I missed a few here and there but did take the meds regularly. Avoiding malaria is much harder than most believe especially when living with host families and not staying in A/C hotels where there are little to no bugs!
I will keep you posted. I am seeing an ID dr at the end of the week at the Brigham!
~*~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case
Just had an appt. today--still no direction. More blood, chest x-ray. Unsure of what this could be because the symptoms are non-specific. However, it is really causing me great difficulty. Theres a chance, I was told, that it is some response to a virus that just needs to run its course be it 3 months, 5 months, 10 months. Then there was talk of early autoimmune, also TB or a tick-borne disease. Have a new strange rash on upper back...about the size of silver dollar and all small red bumps. Not raised.
Any thoughts or suggestions? I am overwhelmed with this illness!!
As the specialist likely discussed with you, the list of possible explanations is rather lengthy because of the non-specific nature of your symptoms (low grade fever, low back and neck pain, rash, and joint pain).
In the meantime, while you are awaiting your testing results, I will try to offer some assistance. However, first, more questions than answers.
1. Have you had a tuberculosis skin test (also called a PPD test)? This test involves the injection of purified protein derivative underneath the skin of your forearm. The test is "read" at 48-72 hours. If the test is positive (the area where you had the injection becomes hard or indurated), then this tells us that you have been exposed to tuberculosis. A positive test can occur in people who do not have symptoms. Your chest x-ray result will be helpful as well. For the most part, your symptoms do not sound like classic TB symptoms.
2. Did you swim in rivers, streams, or lakes when you were in Africa?
3. What treatment did you have for the malaria that you "had twice"?
4. Have you experienced weight loss during the course of your illness?
5. Are you having abdominal pain, diarrhea, or blood in your stool?
6. Where is your chest pain that you are having when you take deep breaths? Center of your chest, right, left, etc?
7. Do you have a cough? If so, is it productive?
8. Is there a pattern to your fevers? For example, do the fevers occur at the same time every day (night) or every couple of days?
9. Does the rash that you have itch?
10. Does anyone in your family have a history of an autoimmune disorder (lupus, polymyositis rheumatica, rheumatoid arthritis)?
Lots of questions from me.
Also, if infectious causes are ruled out, it will likely be helpful for you to be seen by a rheumatologist (specialist in autoimmune disorders).
~*~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
1. I had a negative PPD
2. While I was in Ghana, I did briefly wade in Lake Volta. Not for a long period of time but just to wash off some clay. I know I shouldn't have and I am not an entirely naive traveler, I just tried to travel flexibly and without being a "worry wart".
3. When I was diagnosed with malaria, I was given a packet of pills that were in Mandarin. At the time I was so ill I couldnt advocate and find out more information. I did have a blood test that confirmed the diagnosis both times. The second time I was treated with a drug I believe was called Artemesin and a shot.
4.I have lost a total of 8 pounds since December. I am a healthy person who was at a fine weight