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Suggest Treatment For Bloody Diarrhea And Muscle Weakness
Question: Hi, I became suddenly and acutely ill 9 years ago. I remained very sick for about a year and a half, then gradually got a little better, but I have not been the same since. Lately I feel worse and feel like I am slowly dying. I was 45 and very healthy before I got sick. The sickness came upon me suddenly one Sunday morning. I felt so bad I though I would pass out. I had extremely bloody diaharea, muscle weakness and pain, pressure and pain in my chest. The sickness continued in what I called sick spells. I would have these spells and be extremely ill. They would leave me extremely weak. I lost 10 pounds immediately. I have been to about 20 doctors and the XXXXXXX and White clinic. The only thing they ever find wrong is my eosiniphils are high. Lately they are extremely high, so that I was just referred to the blood specialist. I have done a lot of research since I got sick and I think that I got a parasite, which no one has ever treated me for. Two things that happened right before I got sick. We caught a wild baby rabbit and I swam in a pool that has people from all over the world swimming in it. Like I said I have done a lot of reading and you can get a parasite from a wild animal or even a swimming pool. Can you please help me? Lately it feels like my innards hurt. I am 53 now and I feel like I am about 70 or 80. I have to limit my activities now and I am the sole income in our house so I still have to work.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello !
Thank you for asking on HCM!
I understand your concern and would like to know the tests that you have performed during your consults with different doctors.
What disorders have been excluded by these tests?
You should know that there are different causes of chronic hyperesosinophilia (inflammatory, helmintic infection, autoimmune disorders, tumors etc).
Your medical history and gastro intestinal symptoms raise the supspicions for a helminthic infection.
A wide variety of infectious agents, almost exclusively helminth (worm) parasites, elicit eosinophilia ; only a relatively few, however, elicit a sustained, marked increase in eosinophil levels.
Eosinophilia is highest among parasites with a phase of development that involves migration through tissue (e.g., trichinosis, ascariasis, gnathostomiasis, filarial parasites).
I would mention some specific helmintic infections :
-Angiostrongyloidiasis
-Filarial infections
-Schistosomiasis
-Strongyloidiasis
-Toxocara canis
- Trichinosis.
These infections can manifest with acute gastrointensital signs after the first invasion and then can invade the other tissues and stay there for years, producing their toxins and causing chronic hyperesonophilia. They can live in your digestive tract for years.
It is necessary to perform a wide differential diagnosis of the different causes related to chronic esosinophilia.
Some blood lab tests should be done initially:
-complete blood count
- studies to assess organ function (liver function tests, renal function tests, urinalysis, chest radiograph, abdominal ultrasound)
-inflammation tests (CRP/sedimentation rate)
- immune status (immunoglobulins, IgE).
Further Diagnostic Evaluations (based on initial laboratory findings or localizing symptoms) would be:
-Tissue examination (biopsies) if necessary ( GI tract mucosa through fibrogastroscopy, lung mucosa,etc).
-Specimen collection (CSF, sputum, bronchoalveolar lavage, stool, urine) that can identify the agent
-CT and MRI to define better focal lesions.
-Bone marrow aspirates and biopsies to assess fully the nature of the process underlying the eosinophilia.
Additional disease-defining tests to exclude particular diagnoses (e.g. serum tryptase/cKIT mutations for systemic mastocytosis, antineutrophil cytoplasmic antibodies (ANCA) for CSS and other vasculitides, serologies for helminthes) may be needed.
Besides, I would also recommend performing some blood lab tests to exclude some metabolic disorders like:
thyroid hormone levels (thyroid gland function)
cortisol plasma levels (adrenal gland function)
Vitamin B12 plasma levels (it may be low in chronic GI disorders) .
You should discuss with your GP and an infectious disease specialist on the above mentioned issues.
Hope to have been of help!
Best regards!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello !
Thank you for asking on HCM!
I understand your concern and would like to know the tests that you have performed during your consults with different doctors.
What disorders have been excluded by these tests?
You should know that there are different causes of chronic hyperesosinophilia (inflammatory, helmintic infection, autoimmune disorders, tumors etc).
Your medical history and gastro intestinal symptoms raise the supspicions for a helminthic infection.
A wide variety of infectious agents, almost exclusively helminth (worm) parasites, elicit eosinophilia ; only a relatively few, however, elicit a sustained, marked increase in eosinophil levels.
Eosinophilia is highest among parasites with a phase of development that involves migration through tissue (e.g., trichinosis, ascariasis, gnathostomiasis, filarial parasites).
I would mention some specific helmintic infections :
-Angiostrongyloidiasis
-Filarial infections
-Schistosomiasis
-Strongyloidiasis
-Toxocara canis
- Trichinosis.
These infections can manifest with acute gastrointensital signs after the first invasion and then can invade the other tissues and stay there for years, producing their toxins and causing chronic hyperesonophilia. They can live in your digestive tract for years.
It is necessary to perform a wide differential diagnosis of the different causes related to chronic esosinophilia.
Some blood lab tests should be done initially:
-complete blood count
- studies to assess organ function (liver function tests, renal function tests, urinalysis, chest radiograph, abdominal ultrasound)
-inflammation tests (CRP/sedimentation rate)
- immune status (immunoglobulins, IgE).
Further Diagnostic Evaluations (based on initial laboratory findings or localizing symptoms) would be:
-Tissue examination (biopsies) if necessary ( GI tract mucosa through fibrogastroscopy, lung mucosa,etc).
-Specimen collection (CSF, sputum, bronchoalveolar lavage, stool, urine) that can identify the agent
-CT and MRI to define better focal lesions.
-Bone marrow aspirates and biopsies to assess fully the nature of the process underlying the eosinophilia.
Additional disease-defining tests to exclude particular diagnoses (e.g. serum tryptase/cKIT mutations for systemic mastocytosis, antineutrophil cytoplasmic antibodies (ANCA) for CSS and other vasculitides, serologies for helminthes) may be needed.
Besides, I would also recommend performing some blood lab tests to exclude some metabolic disorders like:
thyroid hormone levels (thyroid gland function)
cortisol plasma levels (adrenal gland function)
Vitamin B12 plasma levels (it may be low in chronic GI disorders) .
You should discuss with your GP and an infectious disease specialist on the above mentioned issues.
Hope to have been of help!
Best regards!
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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