|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: ID/Tropical Medicine question (long)From: Henry Gregor (henrygregor@yahoo.com)Sun Nov 4 16:17:11 2007
Thanks. WIll watch for time being...clinical situation improving, through this afternoon phone followup. I'll keep your words in mind. Hank acmidwife@netscape.net wrote: Hank... One of my good friends spent three years in Bangladesh and returned to the US with similar sx. He had been ill for much longer, so things had progressed. He also had hepato and splenomegaly and something like 50# weight loss. After following the standard treatment regime, they began to watch and wait..... He had arsenic poisoning from the drinking water over there- prolonged exposure. Cumulative effect. Any rate.... he's better, but that was it. Might be worth checking into. Regards ac mase cnm -----Original Message----- From: Henry Gregor <henrygregor@yahoo.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Sent: Sat, 3 Nov 2007 12:22 am Subject: ID/Tropical Medicine question (long) Listers College student worked in Bengladesh, returned to US and worked several weeks in western North Carolina woods as a river guide and backpacking guide, developed profuse nonbloody loose stools. No family hx of IBD. Rx'd for Giardia.n whether this was diagnosed or presumptive dx) w/metronidazole x 7 days. Sx's persisted w/o significant change. Patient returned to original providor, having had 10 lb weight loss, no fevers/chills/rashes/anorexia. Mild to Moderate GI cramps. Stool test positive for Endolimax nana. (Which references tell me is usually non-pathogenic and not generally treated, thought it can cause diarrhea. It can also "be confused" with Entamoeba histolytica - apologies for spellling.) Pt still sx'c, but decreasing number and volume of stools, seven days after treatment with praziquantel, an antihelminthic which I suspect was given presumtively for the possibility of undocumented helminthic infection. Before further stool testing/ID consult/ GI endo studies would another round of treatment with metr'azole or tinidazole be reasonable. Would "watch and wait" for another interval of seven days be reasonable? I know this is off topic and I know Google and Google Scholar and PubMed are our friends, (and I've been on them during a long stand by in L&D tonite), but what could any of you comment re the situation...com'on El, and others,lets hear your thoughts please. It would be helpful for the student to avoid further time in medical waiting rooms and labs, which would take away from a critical time in the school semsester/exam schedule, though of course that can be done in the interest of health first. Thanks, Hank Tired of spam? Yahoo! Mail has the best spam protection around --------------------------------- Check Out the new free AIM(R) Mail -- Unlimited storage and industry-leading spam and email virus protection. ---------------------------------
-- ---------------------------------
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Thu Oct 2 04:58:07 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.