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

<p>Thoughts and prayers w/you and your S...glad to hear things "peaked" enough that your S consented to a doc's visit and referral prior to leaving for school...fingers crossed for him that he gets back ASAP, and for you and him that he starts the convalescence SOON...</p>

<p>Jym26,
Nearly every significant infectious disease gives some variation in the CBC. The degree to which the platelet count, specifically, is affected, is one of the hallmarks of dengue. There is a wide range of normal platelet counts, it is the downward trend that is notable and often dramatic- and then the magnitude of the drop is the signficant factor- whether or not it predisposes to a hemorrhagic process. Your son should have sequential CBC's done...</p>

<p>Typically dengue is a disease where lots of people living in the same area get sick at the same time. They are not contagious to one another, it is because the mosquitos are nearby...anyone else sick from his group?</p>

<p>Diagnosing tropical illnesses is not easy so it would be great if he could see an ID specialist sooner rather than later. The timing is lousy, but given that the school sponsored the trip to begin with, I am sure they will be particularly understanding.</p>

<p>Thanks, everyone.</p>

<p>Robyrm-
I'll see if I can get the labs from teh urgent care place. I was supposed to get a copy of them yesterday, but in all the confusion, I forgot to follow up on that. I have the chest films, but not the labs.</p>

<p>Hazmat-
SARS is terribly contageous, and I can understand why they would quarantine someone. With this, he's not contageous (unless the pneumonia is bacterial-- and he's on an antibiotic).
I'll be away from the computer for most of the day. Will update later. Thanks for all your thoughts.</p>

<p>
[quote]
I asked what was so funny. Apparently younger s. thought older s. had "Ben-Gay" Fever!!

[/quote]
</p>

<p>:D That's hilarious.</p>

<p>Jym, glad to hear he's staying home. Didn't want to come out and say that's what I would do, because I'm not there, but I would want him home. Lab diagnosis of tropical diseases accurately takes a great deal of time here in the US - malaria is easy to diagnose for people who see a lot of it, a bit more of a challenge for those of us who only see a case every 3-4 years, or on tests. most other tropicals like dengue, require blood tests that take days to weeks. Therefore, usually the diagnosis is clinical, and that needs an experienced clinician (ID person). Actually, Houston would be one of the best places in the country for him to get diagnosed, if you could be sure he got into the doc - I would be worried about my sick 19-20 year old navigating through that giant medical complex on his own!.
Your local ID person can get your son directly referred to a specialist in Houston, so that if the local person feels that he can go on back to school, your son can get expert follow-up in Houston without going through as much bureaucracy.</p>

<p>Contacting the disability office, office responsible for the trip or the class dean sounds like a great idea - even if it is just the flu, he's not going to be feeling his best for the first few weeks of school.</p>

<p>Keep us posted, he's in our prayers.</p>

<p>Any chance he picked up a parasite? I had a parasitology class in college that made me absolutely paranoid about traveling outside the country (and parts of the South) for years!</p>

<p>unless the ER doctor happens to be from a different country, I wouldn't count on them to know much about tropical diseases. I've worked in an ER for over 20 years and I've never seen or heard of one of my partners seeing a patient with Dengue Fever or Hantavirus. Everything I know about tropical diseases comes from person travel. Frankly, I wouldn't "count" the trip to the Urgent Care doctor in terms of actually diagnosing what your son has. He needs to go to a specialist, and I wouldn't be surprised if they needed to send blood samples off to the CDC. Houston is a good place to be if you need something like that. They are a gateway for enough tropical countries that there will certainly be some inf. ds. doctors there with the appropriate experience. Good luck. I hope your son is doing better soon.</p>

<p>Jym-Sending good thoughts your way. My S had a medical situation that required attention beyond the scope of the health clinic on campus. Although he assured us he could handle it himself, I flew down to be with him those first few days and help navigate the world of specialists and referrals. He is a competent kid but we felt he didn't have the experience to ask all the right questions and make clear decisions when not 100%. I felt much better (and so did he) with me there until the crisis point passed. Once he was on the mend, I left and he was able to handle all the follow-up himself. </p>

<p>It does sounds as if he needs to stay at home right now, but if he must go back soon, maybe you can go back with him and get him all set up with doctors in Houston. It will be very reassuring for you to meet the docs and have a treatment plan in place. Remember, it is hard to get info from the medical staff over the phone for your own kid if they are over 18. Have him notify his docs that it is ok to speak with you and I would definitely recommend contacting health services and the disability offices at the school. They were a great help with my son and took care of alerting all his profs. You may also want to speak with his roommates and make sure they have your phone number. Good luck.</p>

<p>Update:
Saw the PCP (primary care - who looked very tired, having just flown back into town very late last night) who got us in to see an ID person later today. We happen to be in Atlanta, so communicating with the CDC isn't a problem. I am certainly hopeful that this is "just" pneumonia and an overly zealous ER doc, but the PCP suspects he may have gotten some airborne parasite into his lung, which is what I had postulated at one point. We've put the flight back on hold, and will wait to see what the specialist thinks. At least we will have some organized follow-up. </p>

<p>My s. is feeling some better today, which is either (1) good news or (2) the "good" day between the 2 phases of the illness. The pcp changed his antibiotic (3rd change in 3 days)... Well, at least we've met our deductibles pretty quickly this year :)</p>

<p>jym~</p>

<p>I'm so very glad that your son is receiving good care and that he is home until things are more certain. I'll be thinking good thoughts for you both! Best of luck with the ID specialist. Hope s/he can pinpoint the problem and set your S on the road to recovery! love, ~berurah</p>

<p>jym626</p>

<p>Oh, it is so hard to deal with the unknown! I am so sorry you are dealing with this. It makes me admire all the more the kids who do selfless community service in foreign lands, *(or just live there all you CCers who deal with this daily) . . .
you all will be in my thoughts!</p>

<p>Momof3</p>

<p>Jym-</p>

<p>You may also ask your physician if he can test for "Valley Fever". This is actually when a fungal spore gets inhaled, and gets lodged in the lungs. Apparently the fungal spores are inherent to certain soils in southwestern US and central America. If it is diagnosed, it can be treated with anti-fungal medication. My husband's brother was living in Arizona and contracted it. Unfortunately, they did not accurately diagnose it in time for treatment.</p>

<p><a href="http://www.astdhpphe.org/infect/valley.html%5B/url%5D"&gt;http://www.astdhpphe.org/infect/valley.html&lt;/a&gt;&lt;/p>

<p>I don't want to raise any paranoia here.. but 1sokkermom, do you mean to imply that your husband's brother died? I hope not... if so, my condolences. I had never heard of the illness, and am amazed that it is so unknown and so prevalent.(sp?)</p>

<p>Anxiousmom:</p>

<p>Thank you. Yes, he passed away just about three years ago. We had never heard of the disease either. "Valley Fever" is not the medical term, but if you google that you can find out a lot of information, including the medical fungal term(s). He was a strong, healthy, 35 year old man. He had just gotten married and moved to Arizona from New England to be with his wife's family. He was working as a carpenter at the time, building houses near Sahuarita.
Apparently he had "flu- like symptoms" for a while, but was too stubborn to go see a Doctor. When he finally went to the hospital (with breathing difficulties), it was too late. His lungs had already suffered too much damage. He was put on a ventilator and died wthin a week. </p>

<p>This is not to scare jym. However, we were all told that if he had been diagnosed when he first had symptoms, he probably would be alive today.</p>

<p>1sokkermom,</p>

<p>Oh, that is so very sad. I send my sincere sympathy to you and your family. It is good to be safe when there is no clear cause, and it is good that you wrote.</p>

<p>Thanks for all the info, everyone.
Soccermom-
Turns out that my mother-in-law had Valley Fever many years ago. I hadn't considered this, but I will mention it to the ID specialist. They did bloodwork today- tested for malaria, dengue and a bunch of other stuff, but Valley Fever didn't come up. I'll have to ask when I call tomorrow. It is probably too late to add it to the stuff they ordered today.</p>

<p>Ahhh-- to test for valley fever, you apparently have to cough up a loogie. He can do that anytime :)</p>

<p>jym626-
So sorry your son is ill.
The ID specialist will figure it out. I agree that this is way beyond the scope of an 'urgent care' facility or even an ER.</p>

<p>Valley fever is very common in SW United States and Mexico. I am a microbiologist in NJ but even we see a few cases a year of folks living/travelling to Arizona/New Mexico. Caused by a fungus C. immitis.
There is a serologic test.....we usually grow the organism from a 'loogie'!
Best of luck to your son. I'm sure you're on the right track.</p>

<p>Update:</p>

<p>DS felt much better yesterday, and returned to college. He was supposed to call when he got in, but I last heard from him when he was sitting on the plane. He has a full day of classes scheduled today. I'll see if he survives that. I know he will push himself to go to all of them, despite my recommendations to take it easy. He said that if he could spend all day in Drs offices, like we did on Monday, he could spend all day today in classes. </p>

<p>We are working to get him a referral to an ID person in Houston (I have a friend who is a physician at one of the hospitals who is making a personal call for me) and we will hopefully have him set up for a follow-up appt next week. Preliminary labwork is showing only "inflammation" (which I take to mean an elevated white blood cell count). I am hoping it is "just" pneumonia, followed by an overzealous ER doc suspecting a funky tropical disease. Thanks to all of you for your concern. I'll keep you posted.</p>

<p>Good news. I dread that first real illness away from home - you are handling it well, I think :). It sounds like he is on the mend, yay for friends who can help get referrals set up.</p>