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Forum Name: Other infections

Question: Abdominal pain, headache chills joint soreness after travel


 corbinchampion - Mon Sep 22, 2008 7:17 pm

I am a 27 yr old male. I recently traveled to many many places as part of a long trip. China->India->Thailand->Egypt->Spain->Portugal->Brazil->Peru->home (US). A week after returning I starting getting ill. The symptoms are as follows:
Aug 29th - abdominal pain beings in lower right abdomen.
Aug 30th - headache begins. headache is in the front of the head
Aug 30th - Sept 5th, headache everyday, worse in the morning, abdominal pain from mild to moderate at all times. Some tiredness, some soreness, upset stomach at times.
Sept 5th - Doc appt #1, blood culture done by lab, nothing abnormal.
Sept 6 - 8th - abdominal pain worsens. Soreness spreads to back especially lower back. Mild fever (no more that 100 degrees) at times. Soar throat.
Sept 8th - Doc appt #2, blood smear (malaria) negative, mono (negative)
Sept 9th - 11th - Stomach pain reduces for a few days, but headache, nausea, soreness present daily all day. Daily 97-100 degree swings (not too abnormal) with sensation of being very cold when temp low. Soar throat gone.
Sept 12 - 14 pain spreads to shoulders, knees, hip, groin, inner and outer thigh and elbows. Walking is difficult, especially first few steps. Abdominal pain is back and as bad as ever. Worst pain in upper right leg.
Sept 14 - receive lab suggestions from infectious disease specialist. Tested for HIV, new blood culture, new blood smear, feces taken for parasite test. All negative.
Sept 15 - 17 Abdominal pain has become infrequent. Soreness continues but not too bad. Nausea very bad.
Sept 18 - 22 Abdominal pain still infrequent, less temp variation. Nausea and soreness bad. Feel arthritic with any in-use joint sore. Very fatigued. More fatigued daily. Blood shot eyes, dark bags under eyes, despite more than normal sleep.
Symptoms have come and gone throughout this, but now it is mostly soreness, fatigue, nausea and headache.
I also had a CAT scan taken of my abdomen and nothing abnormal was found.
Today blood was taken to check for lyme disease, thyroid function and mono again.
I have had other tests done that I have forgot to mention like liver function (normal).
I am feeling more tired daily and would appreciate any suggestions that might lead to a quicker resolution of this.
Thanks!
 corbinchampion - Tue Oct 21, 2008 10:34 pm

Please look at this. I am receiving care, but am getting worse. At this point, I am concerned and would appreciate any suggestions and guidance. Here is a detailed look at what I am experiencing:

Age: 27
Sex: Male
Ethnicity: White/Caucasian
Height: 5’7”
Weight: 150lbs.
Symptoms began: 8/29/2008
General health prior: good

Symptoms (in order of discomfort):

Muscle Pain: Hips, Hip Flexors, Thighs, Groin, Hamstring, Buttocks, Knees, Calves sometimes, shoulders, biceps. All pain fluctuates in intensity. Worst pain is in right hip and leg and then the shoulders. Pain is generally dull and achy like the muscle is weak and has been worked out hard. It is like the sensation of having lactic acid built-up in muscles. Some of the muscles are tender to pressure, especially in right leg and hip. Pain is present at all times, but pain is definitely increased by motion. Going uphill or climbing stairs is difficult. Sometimes pain can be sharp.

Abdominal Pain: Originally was specifically in lower right abdomen, but has spread to both sides. Pain is still worse in right side. Pain is present at all times, made slightly worse by movement. Right side is very tender. Worst tenderness is in lower right and if you push up under the ribs at all. Pain is often dull and achy, but also often sharp specifically on right side.

Fatigue: Bad. I tire easily to small amounts of exercise and am tired all day. If I exert myself much, symptoms of pain and headache will flare noticeable, with headache pounding.

Nausea: Present at all times. It varies in intensity. It can be made worse by pushing on abdomen or by quick movements, but not much. No correlation to when I eat.

Headache: Present all day everyday. Often worse in the mornings and evenings. Varies in intensity.

Chills: Often get sensation of being very cold, with hands actually getting cold and sometimes face becomes flush and warm to touch. Temperature measured always between 97-100 degrees.

Joint Pain: I have had joint pain come and go. For sort periods, whatever joint I use (knuckles, elbows knees etc etc) will become soar. Has happened a couple times, lasting for a couple days.

Various other stuff: I have had sharp pains randomly in other areas. I have had a soar throat twice each time for one day. Etc…


Important history:

Traveled just before falling ill to symptoms. From June 17th to Aug 24th, my wife and I traveled around the world. In order we went to China, India, Thailand, Egypt, Spain, Portugal, Brazil, Peru, home to US. My wife did not get sick. During the trip, I only had normal food issues, especially in India.

Traveled last summer to East Africa, where I was diagnosed with and treated for malaria in Tansania, specifically Plasmodium Falcipirum. First treatment didn’t fully kill it with symptoms returning when medicine finished. Second treatment worked with no symptoms afterwards and a clean bill of health when I returned home.

When I was born I had a heart murmur, but it hasn’t been detected since I was 8.

Lab Results:

I have included all my results below, but the only interesting results were more recently with CPK noticeably high and ESR slightly high. Also, we noticed that my AST doubled recently. Also, my indirect billirubin is always slightly high.

In addition to what is shown below I have had 2 CT scans of my abdomen, an ultrasound of my abdomen and a CT scan of my head. I have also had a upper GI and small bowel series of x-rays taken as well as a colonoscopy. All of these came back normal. I have also taken a mental test, the Shidler test (sp) and I was found to be normal. No history of depression or other mental illnesses. I was stress for a few days when I returned home though.

Date Test Component Result Expected Flag
9/5/2008 BILIRUBIN, DIRECT Direct Bili 0.3 < 0.4- mg/dL
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE Specific Gravity 1.022 1.003-1.035
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE Leukocytes Neg Negative-
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE Nitrite, Ur Neg Negative-
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE pH 8.0 4.5-8.0
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE Protein Neg Negative-
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE Glucose Neg Negative- mg/dL
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE Ketones Neg Negative-
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE Bilirubin Neg Negative-
9/5/2008 URINALYSIS WITH REFLEX TO MICROSCOPY AND CULTURE UA Hgb Neg Negative-
9/5/2008 COMPREHENSIVE METABOLIC PANEL Sodium 138 136-148 mmol/L
9/5/2008 COMPREHENSIVE METABOLIC PANEL Potassium 3.9 3.5-5.1 mmol/L
9/5/2008 COMPREHENSIVE METABOLIC PANEL Chloride 102 97-109 mmol/L
9/5/2008 COMPREHENSIVE METABOLIC PANEL CO2 28 22-32 mmol/L
9/5/2008 COMPREHENSIVE METABOLIC PANEL Glucose, Random 91 < 201- mg/dL
9/5/2008 COMPREHENSIVE METABOLIC PANEL BUN 11 9-25 mg/dL
9/5/2008 COMPREHENSIVE METABOLIC PANEL Creatinine 0.9 0.6-1.3 mg/dL
9/5/2008 COMPREHENSIVE METABOLIC PANEL GFR Afr Amer (MDRD) 122 -
9/5/2008 COMPREHENSIVE METABOLIC PANEL GFR nonAfrAmer (MDRD) 101 -
9/5/2008 COMPREHENSIVE METABOLIC PANEL Total Bili 1.6 < 1.2- mg/dL H
9/5/2008 COMPREHENSIVE METABOLIC PANEL Total Protein 7.6 6.4-8.0 g/dL
9/5/2008 COMPREHENSIVE METABOLIC PANEL Albumin 4.7 3.40-5.20 g/dL
9/5/2008 COMPREHENSIVE METABOLIC PANEL AST (GOT) 23 5-43 U/L
9/5/2008 COMPREHENSIVE METABOLIC PANEL ALT (SGPT) 28 10-58 U/L
9/5/2008 COMPREHENSIVE METABOLIC PANEL Alk Phos 64 40-129 U/L
9/5/2008 COMPREHENSIVE METABOLIC PANEL Calcium 9.7 8.4-10.2 mg/dL
9/5/2008 BLOOD PARASITE, MALARIA Blood Parasite Neg Negative-
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO WBC 7.5 4.0-10.5 x 10 9/L
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RBC 5.06 4.00-5.50 x 10 12/L
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Hemoglobin 15.8 13.0-17.0 g/dL
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Hematocrit 46.8 37.0-50.0 %
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCV 92.5 82.0-100.0 fL
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCH 31.2 28.0-35.0 pg
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCHC 33.8 31.0-36.5 g/dL
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Platelet Count 307 140-375 x 10 9/L
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RDW, SD 42.3 36.0-50.0 fL
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RDW, CV 12.6 11.0-14.0 %
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MPV 11.4 8.6-12.0 fL
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Neutrophils 57.4 - %
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Lymphocytes 30.3 - %
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Monocytes 9.9 - %
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Eosinophils 2.1 - %
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Basophils 0.3 - %
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Neutrophils 4.3 1.80-8.30 x 10 9/L
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Lymphocytes 2.27 1.00-4.80 x 10 9/L
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Monocytes 0.74 0.00-0.90 x 10 9/L
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Eosinophils 0.16 0.00-0.40 x 10 9/L
9/5/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Basophils 0.02 0.00-0.20 x 10 9/L
9/12/2008 CYTOMEGALOVIRUS IGM CMV IgM Ab <0.91 <0.91
9/12/2008 HIV 1/2 ANTIBODY HIV-1/2 SCREEN Non reactive -
9/12/2008 MONO TEST Heterophile Ab Negative -
9/12/2008 BLOOD PARASITE, MALARIA Blood Parasite Neg Negative-
9/12/2008 LYME DISEASE Lyme Neg Negative-
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO WBC 7 4.0-10.5 x 10 9/L
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RBC 4.63 4.00-5.50 x 10 12/L
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Hemoglobin 14.6 13.0-17.0 g/dL
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Hematocrit 42.9 37.0-50.0 %
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCV 92.7 82.0-100.0 fL
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCH 31.5 28.0-35.0 pg
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCHC 34 31.0-36.5 g/dL
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Platelet Count 302 140-375 x 10 9/L
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RDW, SD 42.2 36.0-50.0 fL
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RDW, CV 12.6 11.0-14.0 %
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MPV 11.4 8.6-12.0 fL
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Neutrophils 56.6 - %
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Lymphocytes 32.8 - %
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Monocytes 8.6 - %
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Eosinophils 1.9 - %
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Basophils 0.1 - %
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Neutrophils 3.96 1.80-8.30 x 10 9/L
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Lymphocytes 2.3 1.00-4.80 x 10 9/L
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Monocytes 0.6 0.00-0.90 x 10 9/L
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Eosinophils 0.13 0.00-0.40 x 10 9/L
9/17/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Basophils 0.01 0.00-0.20 x 10 9/L
9/17/2008 ALKALINE PHOSPHATASE Alk Phos 65 40-129 U/L
9/17/2008 AST (ASPARTATE AMINOTRANSFERASE), SERUM AST (GOT) 23 5-43 U/L
9/22/2008 TSH (THYROID STIMULATING HORMONE) WITH REFLEX TO FREE T4 TSH 2 0.34-5.60 uIU/mL
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO WBC 7.5 4.0-10.5 x 10 9/L
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RBC 4.66 4.00-5.50 x 10 12/L
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Hemoglobin 14.4 13.0-17.0 g/dL
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Hematocrit 42.8 37.0-50.0 %
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCV 91.8 82.0-100.0 fL
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCH 30.9 28.0-35.0 pg
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MCHC 33.6 31.0-36.5 g/dL
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO Platelet Count 292 140-375 x 10 9/L
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RDW, SD 42.1 36.0-50.0 fL
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO RDW, CV 12.5 11.0-14.0 %
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO MPV 11.1 8.6-12.0 fL
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Neutrophils 61.5 - %
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Lymphocytes 28.3 - %
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Monocytes 8 - %
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Eosinophils 2.1 - %
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO % Basophils 0.1 - %
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Neutrophils 4.61 1.80-8.30 x 10 9/L
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Lymphocytes 2.12 1.00-4.80 x 10 9/L
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Monocytes 0.6 0.00-0.90 x 10 9/L
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Eosinophils 0.16 0.00-0.40 x 10 9/L
9/26/2008 CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL, AUTO # Basophils 0.01 0.00-0.20 x 10 9/L
10/13/2008 BILIRUBIN, DIRECT Direct Bili 0.2 < 0.4- mg/dL
10/13/2008 CREATINE KINASE CK (CPK) 756 24-206 U/L H
10/13/2008 C-REACTIVE PROTEIN C-reactive protein 0.1 < 0.9- mg/dl
10/13/2008 ERYTHROCYTE SEDIMENTATION RATE, AUTOMATED ESR 23 < 21- mm/hr H
10/13/2008 LIVER FUNCTION PANEL Total Bili 1.2 < 1.2- mg/dL H
10/13/2008 LIVER FUNCTION PANEL Direct Bili 0.2 < 0.4- mg/dL
10/13/2008 LIVER FUNCTION PANEL Total Protein 7.9 6.4-8.0 g/dL
10/13/2008 LIVER FUNCTION PANEL Albumin 4.8 3.40-5.20 g/dL
10/13/2008 LIVER FUNCTION PANEL Alk Phos 70 40-129 U/L
10/13/2008 LIVER FUNCTION PANEL AST (GOT) 42 5-43 U/L
10/13/2008 LIVER FUNCTION PANEL ALT (SGPT) 33 10-58 U/L
10/17/2008 RHEUMATOID FACTOR, SERUM Rheumatoid factor < 20 < 20- IU/mL
10/17/2008 ANA (ANTINUCLEAR ANTIBODY) ANA Screen Negative -

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