Hoping for some input from docs or those who have been through this.

After a trip t Botswana (Tuli) without anti- malarials, I came home and went to bed for 2 weeks with flu like symptoms. Went to Scripps Hospital in la Jolla, and they said--you're sick, we don't know what it is, but it is not malaria, and we don't see tick bites.

Since then (2007) I have been wiped out every 3-6 months with those once in a decade flu like knock down, wiped out, bedridden for a week solid illness.

When they test for flu, it is negative (with the nose swab), and nobody gets the flu 3-4 times a year.

Have been seen by multiple specialists and had all the tests- nothing. The latest doc said she didn't think it was Africa related, while scanning the CDC site---

These issues are seen so rarely here- does anyone have similar experiences or can you shed light on it?

Typically a course of antibiotics helps (or time) who knows.

Hi Joel:

Sorry to hear you haven't been feeling well.

I've had the same thing going on for the past 6 years. I rarely ever got sick before. If I did I was over it in a day or two. Now when I get sick I get really sick and it just hangs on for a month or two.

I've had all the tests too and the doctor says it will just run its course if the antibiotics don't help. I think we have some nasty bugs going around. I just got over a bug a few weeks ago that I caught the week before SCI. This one had flu type symptoms, bad stomach, congested, cough and off and on fever.

I never felt sick while in Africa. Maybe going back is the cure!

I hope you are feeling better! Let’s see what others post.

Sincerely,
Jack

Maybe it would be a good idea to check into one of South Africa's better hospitals for testing. It's been my experience that doctors here are reluctant to look outside their usual realm of experience.

Bill Quimby

Yeah or even find a good diseases specialist in Africa who could take a call from you??

Hey guys, might be able to add something to this puzzle. Something got me too, also in SoCal, and also in 2007.

404,

Does not sound like malaria as you would be very sick by this time. Note most tests for malaria are initially negative.

Does sound like tick fever or possibly sleeping sickness and I would advise so get treated for them all.

Can put you in touch with a very good doctor here if need be.

Andrew

Have they tested you for Bilharzia ?

And my wife's malaria was misdiagnosed , she ended up in a coma for 59 days,

So since then we have treated anything questionable with Malaria meds, if you do not have malaria, the meds wont kill you, if you hav malaria and the doctors can not see it, you get cured. A win win situation

Bilharzia
Tick Bite fever
Trypanosomiasis(sleeping sickness)

All of the above could be the problem. As suggested above I would consult a tropical diseases hospital and go from there. Blood tests mean absolutely nothing if they dont know what they are looking for.

The problem with so many tropical diseases are that symptoms often tend to be many, varied and vague but you might like to consider having a proper/thorough post tropical check up done in a specialist unit and has already been suggested, possibly have them look especially for bilharzia.

Just in case you do still have ticks on you still, try using a (non toxic) dog tick and flea shamoo instead of shower gel/soap for a few days and be VERY thorough with it.

If you're taking a lot of antibiotics, you might like to also take regular doses of live acidophilis or as a second best, eat lots of live yoghurt to prevent you getting thrush.

If that little lot sounds like overkill, I was taught to be cautious.

You know, there are four different types of malaria. Not all get that caused by the falciparum type. The less common ones don't have as many parasites in the blood cells and are harder to diagnose as well. In addition, there are few places in the U.S.A. where the lab techs are good enough reading thick films to dependably diagnose malaria. Another disease with a recurrent febrile cycle would be brucellosis.

You would probably do well to consult a physician familiar with tropical medicine such as one who practices in or has practiced in RSA or another place where malaria is more common. Empiric antimalarial treatment could also be considered.

Interestingly my father, deceased many years, diagnosed a couple of cases of malaria in California. Much of Mexico is also considered a malaria endemic area.

Also get them to test for Rocky Mountain Spotted fever, I have a friend who had it and it has the same symtoms. Don't rule out that You might not have contracted it in Africa.

Lymes disease?????

Sorry to hear about your health problems. The timing of your first symptoms certainly seems to indicate that you may have contracted something in Botswana.

If I were you, I would see the best dedicated tropical, infectious disease specialist I could find, ideally one with experience diagnosing and treating African tropical diseases.

404,

In 2007 I returned from Zim and started feeling like hell on the return flight. Next day into the ER with a temperature of 104. Spent 8 days hovering near what I felt was death. I had an infectious disease group anal probe me for everything. Interesting enough, on day 2 I told the ID guru that they wouldn't figure out what the problem was. Of course I was dismissed and he announced that "of course we will figure out what the problem is!" Guess what? Not so much. I had no awareness of tick, spider or other bite and was in a tetse control area around Ghonerezhou. I have not had any recurrences, but haven't ruled out the possibility.

In spite of my experience, I would get on board with an Infectious Disease Specialist. Before and after you have symptons would be ideal. Don't get me wrong, I received good care. They just never figured out what the culprit was or is.

Jeff

404WJJeffery -

Do you know if they did a titer for any inflammation or ran a strep test. I had a patient with similiar symptoms as yours and it turned out to be systemic strep that would manifest when the patients immune system was compromised or run down. This would be rare but may be a differential diagnosis.


ddj

404,,, any bone/joint soreness or stiffness? What does your body temperature do during these episodes? Any fever spikes, etc.? Headaches before or during these episodes? Questions you need to think about before you see a infectious disease specialist. Most MD's run antibiotics for only a week to 10 days,,, Our MSA resistant staph and other super bugs don't just linger around very often, they chew you up if the antibiotics don't get it under controll while your immune system kicks in. The weird virus and parasites that you can run into over the pond may require long term antibiotics, antivirals or antimalarials. You need to get to someone who can think out of the box for what is seen here in the US.
On another direction,, have you eaten any shell fish, oysters, sushi etc.? Raw Meat? Since Huricane Katrina in the gulf, there has been a huge increase in raw fish related illneses especially here in the south, really strange illnesses that are hard to diagnose and treat.
Don't just hope this goes away, get to someone who has experience with overseas illneses.

As trouthunter said,, this could be something just under your bodies immune system radar and everytime you get fatigued or stressed it jumps all over you again, stay after it.

How about Lyme disease?

Mike

I agree with those who suggest getting checked out in Africa. Doctors in this country, even tropical disease specialists, are sometimes dumbfounded by diseases that third world doctors are very familiar with. Perhaps you could take a hunting trip and have doctor visits scheduled at each end.

Will your insurance companies cover you for referal and travel to a specialist doctor in another country??? Just a thought!!

You might PM Dave Fulson and ask which specialist he used...he had a similar type thing for a while not too long ago. He might be helpful.

I would not rule out malaria and keep the other 3 Zimfrosty mentioned in mind. As well as, as other mentioned, our own tick-bite fevers Lymes & Rocky Mountain Spotted Fever...and...also Q-fever. Q-fever flies around under the radar here in TX quite a bit...most small rumenants carry it.

Yes, PM me as I will help if I can. 28 blood tests and 24 pounds later they never figured mine out. Got a parasite in CAR and death would have been a blessing a couple of times. I had a tropical disease specialist in Dallas ( but raised in Ethiopia) scratching his head for 2 months. Dracula took less blood over his centuries as this guy did from me ! My office is 214-360-9599) would be glad to chat although I might shed very little light. Hang tough buddy.

quote:

Originally posted by retreever:
How about Lyme disease?

Mike

Mike, It's posssible to be Lymes DZ, but a course of Doxycycline will knock it out. 20% of Lymes cases are seronegative. Had that in 99 and after being tested etc. I finally put myself on Doxy and Bam, cleared up almost immediately.

Jeff

+1 on the lymes. Caught it in '04. It took several rounds of doxy and about 14 months for the symptoms to subside.

quote:

Originally posted by Bwana Bunduki:
404,

In 2007 I returned from Zim and started feeling like hell on the return flight. Next day into the ER with a temperature of 104. Spent 8 days hovering near what I felt was death. I had an infectious disease group anal probe me for everything. Interesting enough, on day 2 I told the ID guru that they wouldn't figure out what the problem was. Of course I was dismissed and he announced that "of course we will figure out what the problem is!" Guess what? Not so much. I had no awareness of tick, spider or other bite and was in a tetse control area around Ghonerezhou. I have not had any recurrences, but haven't ruled out the possibility.

In spite of my experience, I would get on board with an Infectious Disease Specialist. Before and after you have symptons would be ideal. Don't get me wrong, I received good care. They just never figured out what the culprit was or is.

Jeff

That is called home sickness.

I'm betting on lyme disease, too. I had the same thing happen to me. The doctors kept insisting that I DIDN'T have lyme disease. I finally insisted I get tested for it and lo and behold, I had the antibodies. Went on a one-month cycle of antibiotics and haven't had problems since.

Readjusting to all the steroids and crap in our processed food after leaving bush camp....

You don't necessarily have to go back to Africa to find excellent tropical disease care. The Paris area has 4 hospitals with tropical medecine departments, including an emergency tropical medicine unit near the Orly airport for 24 hour service and daily consultations with tropical medicine specialist doctors. Here's a link:

http://www.routard.com/guide_v...oyages_tropicaux.htm

As you probably know, there are alot of French living in Africa, alot of French doctors who specialize in tropical medicine and alot of Africans who come to Paris for medical treatment.

If you were in So. Cal., AZ, Old Mexico or even S. America it could be Valley Fever (Coccidioidomycosis). Took them several years to figure it out in me and I assumed it was from Africa. Turned out it was from right here at home.

Just a simple blood test, but somebody has to think to do it.

Best of luck.

Not an MD but I would suspect possible tick bite fever. I came home with it in 2004 and would feel better than almost collapse. Mt Dr treated me for it after I almost seld diagnosed withy help from this forum and the net. He later studied it at a confrence and said that many DRs here know little if anything about it. Find a Dr that specializes in this or is willing to do the research to find what it is before you wind up with damage that is lasting. Just my two cents.

Thank you all so much for your attention and kind words. I am pretty weak so can't write much.


Yes, could be straight up Lyme, or Rocky Mtn Spotted disease, but since they didn;t see active bites, they didn't test for it....!



Similar to Jack who posted early in the thread (Hi Jack), before this, I was pretty much bullet proof, rarely ill, and if I did get sick, I bounced back quickly.

The only times I was as sick as this in 45 years prior was a bout of salmonella (bad Chinese food) and the bad flu circulating in 1978.

Now I have been absolutely flattened at least 8-10 times since the initial illness.


I appreciate the posts of all, the docs, and the PMs.

To answer specifics.

It comes on like thunder- very quickly, like the flu, fever for 2-4 days (104 far/35 cel,), extreme sharp headache, body ache, and yes joint pain, no runs, no vomiting, down time of a week minimum, worst was 2 weeks.

So generally like an infection.

Trouble is docs here do just want to hydrate you, give you 10 days of doxycycline and say -who knows?

Need to find a specialist, I think Duke has a team, I will look into in there I suppose. I know I would be in better hands with a doc in Africa.

Yes, I think it definitely comes on with fatigue and stress, when one is run down, which usually correspond with getting sick at the worst times eg

laid up in bed Christmas eve and day with the house full of family and no help to my wife, on my birthday, at the start of our grand summer vacation, this week when I had business meetings I was pushing for literally months to put together.

Apart from being ill if there is some parasite lingering around, or bug, it cannot be too good for long term health.


Thanks for listening.

I will print up the suggestions and perhaps take up a couple of offers to be in touch with real Africa docs as well.

I have learned from the posts that docs here don't really care, and don't know what tests to give, or how to read them, or what to prescribe, I think it will be an uphill battle.

Remember, in the US, even with great health care, you need a referral to a specialist - per the rules of the doc, not insurance, so that will be my first challenge.

Heartfelt thanks to all

404,

After our trip in 2000 to Zimbabwe, we were invited to Lou Hallamore's home. While we were there, he looked at Paul and myself and knew were were both sick. He told us we probably had African Tick Bite Fever.

Lou Hallamore told us when we got back to the States to tell our doctor we need a 10 day course of Tetracycline because we have African Tick Bite Fever and we would be tested (in the States) and they would never find out what it was. We were prescribed the Tetracycline and within a couple days were starting to feel back to normal, but you must take the whole course of antibiotics.

The ticks are called pepper ticks and you cannot see the bites.

To avoid this in the future, use your Deet and shower in the evening to make sure they wash off of you. We showered in the morning so they probably spent the night with us.

Our symptoms were flu-like. Fever would spike very high, sweat poured off of us, then everything would be normal for awhile, then back again. Exactly as Lou Hallamore explained it would be.

When we told the doctor we had African tick bite fever and that we needed Tetracycline, he looked at us and said "what?", ok. Lou Hallamore was right and what an awesome experience to meet Lou Hallamore!

It would not hurt to try this. Hope you feel better and let us know the results.

Charlotte, Paul K's wife

Joel,
The board has come up with a good differential. Best advice I can offer is to get a referral to Dr Corey at Duke ID-I don't know him but went thru the faculty bios and he would appear to have best background in tropical/travel medicine. We have several excellent ID docs here at UVA I know personally- if you strike out there PM me and I'll see what I can do.
Bill

Thanks Bill- you are the best! I'll keep you posted.

Obviously the Infectious Disease Dr is first stop on the list. Could be a malaria form, or tick, or other.

When I had a similar symptoms after being in the jungle, but more persistant problems,
they treated me for Hepatitis. After a couple of weeks it seemed Ok. Then I had one more occurrence and treatment again then it just went away. Not sure that was what it was but glad it was gone.

Does not sound like an ameoba, or dysentery, but a parasite could still be there and worth a look.

The list of flu-like or malaria-like tropical diseases is pretty long. The majority of doctors who do not work specifically with tropical medecine aren't usually the best source of information.

As for recent options on the shopping list there is always Chikungunya:

http://www.cdc.gov/ncidod/dvbid/chikungunya/

My South African buddy got Rocky Mountain fever in Canada but the doctors didn't recognize it. He finally called his old doctor in SA and he was able to diagnose it over the phone. Buddy went and got a prescription from the Canadian doctor and the problem was cleared up.

I got tick bite fever in SA and it's not too much fun. I went to buddy's doctor in SA and was given tetrycline (sp) for 20 days and it cleared up well. I had an obvious tick bite in a not so obvious place so it was easy for the doc to see. A north american doctor probably would miss that kind of thing.

Hope you find your health soon.

Joel, best of luck finding the right doctor and the right solution.

I can't add much to what has already been stated other than echoing the need to get an opinion from an infectious disease specialist.
In my own experience, my primary and ER docs couldn't find their ass with two hands, insisting that my persistant headaches and malaise were from a sinus infection or a migraine.
Turns out that I had viral meningitis and Lyme disease.
My hero was the infectious disease doc, Norman Fujita. He took one look at me (in the ICU btw) and pretty much knew what was going on.
The official diagnosis was meningoencephalopathy and Lyme disease. Damn near killed me. Ironically, once recovered, when I went to my primary's office to get my charts so I could find a new doctor, he had returned to UCLA to study infectious diseases. Guess he snoozed through that course in med school...

404, the reason I asked about joint bone pain is I have seen several patients with Lyme's disease who had negative blood cultures, blood antibody titers, patients who had never left home or been in the woods who were treated for Arthritis to gout,, with no long term improvement. Where they contracted it I don't know but several had to have IV Doxy/tetracycline therapy for over 6 weeks and daily treatment for almost a year before clearing things up. With the state of health care today, docs don't have the luxury of time to talk and "listen" to our self diagnosis. Also with insurance you have to justify the tests they run before it will pay,,Stay after them and make them run titers, several times, etc if necessary to put this thing to rest so you can go back to the field,,

quote:

Originally posted by Michael Robinson:
If I were you, I would see the best dedicated tropical, infectious disease specialist I could find, ideally one with experience diagnosing and treating African tropical diseases.

My thoughts exactly.

There are 4 types of Malaria:
p. malariae
p. vivax
p. ovale
p. falciparum

If it is Malaria, it might be p. Ovale. It is not normally deadly, like p. falciparum, which, if left untreated, would likely kill you. I believe it is Ovale that comes back every so often.

Malaria is tough to detect. I would ask a good I.D. Doc. Like Michael Robinson said.

Even a strong bout of p. falcipirum can easily test negative.