"Letting go" follow-up: Any Infectious disease specialists out there???

<p>Well, It will be even harder to let older s. go tomorrow, as the ER doc thinks that, in addition to pneumonia, that he has Dengue fever. Another, probably remoter possibility, is Hantavirus. S. spent 2 weeks in a remote part of Nicaragua, doing volunteer work with the "Engineers Without Borders". He has been terribly ill with what we assumed was the flu, but his incredible spikes in fever, along with a bunch of other symptoms, have led the docs to suspect one of the two mentioned above. S. is scheduled to go back to college and will have to follow up with the health clinic there. Hopefully he'll get sent to an Infectious Diseases specialist. In the meantime, anyone out there have any experience with these?? Serology wasn't done at this point, with expectatin that it'll be done when he gets back to school. However, S. has a tendency to minimize medical sx. He prefers the "ignore it and it will go away" practice of medicine. He has at least agreed to take the antibiotic for the pneumonia. That's a start. But, this nervous nelly mom isn't all too happy that he'll be out of our oversight as of tomorrow. Any ideas???</p>

<p>I spent a few weeks during winter vacation in Mexico, and later got ill. Regular M.D. kept treating it as mono, but then I saw specialist. Treated for paratyphoid and finally got better (3 months of fatigue and fevers). Definitely go with I.D. doctor and get the best treatment possible.
(This was many years ago)</p>

<p>med schools with a public health programs have many docs who have seen first hand tropical infectious diseases, so, if nearby, obtain a referral.</p>

<p>Thanks, bookworm.
He took anti-malarial meds, a typhoid preventative and a Hepatitis-B vaccine. So I'm guessing it isnt typhoid. However, who knows. He goes to school right by the huge Houston Medical Centers, so finding an infectious disease specialist isn't a problem. Getting him to follow up and see a specialist.. that may take some work. He's not too keen on that idea right now :(</p>

<p><strong>edit</strong> Just saw your note, bluebayou. I am going to ck with my Houston contacts to get names of some I.D. specialists. Anyone out there have any reccs??</p>

<p>jym626, I am truly sorry to hear about your son. We lived in tropical countries for about 9 years and my experience with dengue fever still sends shivers of fear up my spine. It is important that your son receive an accurate diagnosis as there are 4 different types of dengue fever. In fact, I would want a diagnosis before sending him back to school, although I'm not sure if the labs in the States are equipped to give an immediate diagnosis. Dengue is aptly named "break-bone" fever as the pain can be rather intense.</p>

<p>So w/o a proper diagnosis there is no requirement to report this illness? Does your S live in group housing? While I can perhaps understand your son's reluctance to take medications as a personal decision......risking the health of other students doesn't seem to be a decision I could support. I am curious what your feelings about this are.</p>

<p>Dengue fever is a disease carried by mosquitos.</p>

<p>I would be very concerned about sending my child back to school if he was sick at all, let alone "terribly ill", especially if you feel he might not pursue appropriate treatment. Could his condition be contagious? I understand that he is scheduled to return but this sounds like something that should be diagnosed and treated right away!</p>

<p>jym626, I don't want to be an alarmist, but if there is a possibility that your son has dengue, he should not go back to school until you make sure that he does not have dengue hemorrhagic fever, which is the most severe form of dengue. The other problem with dengue is that your son may not be physically capable of getting out of bed to go to the doctor. Dengue fever is not contagious from person to person.</p>

<p>Hasmat, bridie-
As liland mentioned, the only way Dengue is spread is by mosquito, and Hantavirus is by rodent droppings. That isn't an issue. And he lives off campus this year. No risk of any outbreak. </p>

<p>He's setting up a follow-up appointment with the health clinic as a starting point, but he tends to prefer to let viral things run their course. He is on an antibiotic for the pneumonia, and has lactobacillus for his gut, to avoid the chance that he'll have another bad reaction to an antibiotic (as he did last year).</p>

<p>He is feeling somewhat better, and when he get the fever down with tylenol or advil, he feels better (chills, muscle aches are minimal). So, I do feel ok letting him get back to Houston. I am just trying to get as much info as I can to feel that we are on the right path.</p>

<p>It took 3 trips to the local Urgent Care place (and being seen finally by the ER doc, rather than the PA-- no offense to any PA's out there) for them to recognize that perhaps this wasn't just a run-of-the-mill flu virus. I am sure I became a tad "high maintenance", but with good reason. At least his symptoms aren't being minimized any more. I am trying to cover all our bases as he returns. I certainly wouldn't let him get on the plane if he wasn't well enough to fly. thanks to all for your help and concern.</p>

<p>liland-
I asked about Dengue hemmoragic (as I sat in the docs office with my nose in the Merck Manual, and came home to research on the CDC website). It is apparently pretty uncommon to have Dengue hemmoragic at age 19 (it is morecommon in little kids), and as he's been ill for almost a week, I think that would have presented itself by now. Fortunately, no bruising, no pettechiae (sp??) or other evidence of bleeding. But, as I've already been accused by my family of being an alarmist, all your comments are making me feel that my concern is appropriate. I live in a house full of males, who all seem to think they are invinceable. They thought I was being silly for continuing to follow up with the urgent care place. I, however, am glad I did.</p>

<p>Please keep us posted as to how he is managing, jym. This must be very hard for you. Would he consider taking a semester off?</p>

<p>
[quote]
Would he consider taking a semester off?

[/quote]

Asap-
I know it wasn't intentional, but your question made me laugh (which I really needed :) )
It's all I can do to get him to go to the doctor, and maybe, MAYBE take less than the 20 hours he is currently scheduled to take. (He realizes that schedule is excessive,with the intense courses he takes).</p>

<p>The good news is, he's not stupid-- just stubborn. He's promised to see the doc who saw the whole group before they went to Nicaragua, and who prescribed the anti-malarial, the typhoid and Hep-B prophylaxes. He'll call the school health clinic in the morning from here, and get himself an app't for Tuesday (hopefully). Classes start on Weds. The doc here said that he can go to classes-- just needs to watch his symptoms. I was really hoping the doc would have been more heavy-handed, but he wasn't. He seems to think the virus will run its course, but he wanted to treat the pneumonia. (thank heavens! :eek: )</p>

<p>jym626: I know nothing about medical stuff, but just wanted to say that I'm sorry to hear your son is sick. Hope he gets better soon.</p>

<p>I've had dengue fever about 25 years ago, just a few days before my wedding. It took me about a month to recover. I used to live in India then. There were terrible bodyaches and extreme tiredness. I've also had malaria in India more than 26 years ago...</p>

<p>In any case, my suggestion would be to take it easy for a few weeks in college if he's going to go back. Is that possible?</p>

<p>Or at least take a schedule somewhat lighter than other semesters...drive instead of walk to campus. Don't go to the gym for a few weeks etc. It saps all energy out of you.</p>

<p>But congrats on going to Nicaragua. Wow. I am just back from India in December....I got bitten all over. I still have the bruises to show for it....thank heaven no dengue this time.</p>

<p>I too wish your S a complete recovery and hope he is not taking on more than he can chew, given his condition!</p>

<p>Minimal muscle aches does not sound like dengue, at least not the more severe versions.
I would stay severe on his butt! It sounds as if the treatable things are being covered, the important thing is to monitor for evidence that this is a more severe viral illness than flu or adenovirus, etc. Insist that he make his follow-up appointment, and that he tell them his history of overseas travel, and that he take his temperature daily. Rashes with fever are bad - immediate trip to seek help. Simple questions to ask are what did you do after class? he should be resting, but if he collapses into bed, or has trouble climbing the stairs or walking back to his room, then he needs to get over to the health clinic. His fever should resolve quickly with Tylenol Advil, etc, and his fevers should be subsiding now that he is on the antibiotics. Basically, he should begin to get better now.
Malaria is possible, even after a course of anti-malarials, that is one reason to insist on the follow-up visit.</p>

<p>Chances are he just has a respiratory virus, complicated by overseas travel, strange food, etc etc, and this will resolve with rest and care.</p>

<p>jym626, First of all, I'm so relieved that your son is feeling somewhat better! I didn't realize that he has been ill for almost a week -- I agree that you would have already seen symptoms of dengue hemorrhagic fever.
And yes!!! Your concern was appropriate, but I do know what you mean about living in a house full of males! To make sure that I wasn't going overboard, I asked my husband to read your post and he told me that I had to write to you about the risks associated with dengue. So...it is serious...and that is from a male who has had dengue!
I don't know if your son's doctor warned him, but your son may get a rash after the fever subsides.</p>

<p>Achat and weenie-
Thanks to both of you for the good wishes and the info.
I am hopeful that he will take it slow,and as it is the beginning of the semester, I hope that is easier to do. I will cross my fingers that the level-headed part of him will take over and he will pace himself. Besides, he's more concerned that if he gets really sick, it will be a bad thing for the E.W.B. group and their upcoming travel plans back to Nicaragua, so he has a vested interest in getting better. </p>

<p><strong>HEY</strong> the Urgent care doc just called to see how he was feeling. How cool is that?? I asked him what the lieklihood was of Hantavirus, and he said he thought that was pretty remote. His money is still on Dengue Fever. </p>

<p>My boys are downstairs laughing uproariously right now (what a pleasant sound). I asked what was so funny. Apparently younger s. thought older s. had "Ben-Gay" Fever!!</p>