What could this be???

[diveluv]

My husband and I were diving in Roatan in May 2002. Since then (one year) my husband has been fighting a NASTY red rash. Now, he's also getting a stabbing pain in his stomach (especially at night).

We've been to tons of travel docs and dermatologists. He's had cortizone shots(which help for a few weeks then the rash comes right back), he's been on medrol packs and prednisone (same response to both).

There are a few things I'm thinking are possibilities:
1. a parasite from something he ate (like shellfish) that is living in his system
2. a sting from some kind of coral that could be living under his skin???
3. a deet reaction
4. an infection from some kind of bug bite (like no-see-ems or mosquitos)

I have searched and searched for things that you can get in Honduras and really can't find a concrete list of possibilities. I just don't know where to turn.

All the dermatologists say he might have to take a cortizone shot every three weeks for the rest of his life. I don't think this is the right approach.

I'm trying to find out what possible infections/parasites anything are possible to get in Honduras. I would also like to know what specialty doctor we should try to find to solve this.
Any suggestions greatly appreciated.
Thank you.

 

[annie]

Hi

Have any of the doctors made any suggestions as to the cause of this or are they just treating the rash symptom?

Sounds terrible - don't worry you'll figure it out.

Ann

 

[ssra30]

Ouch, sorry to hear about the problem your husband is going through. My knowledge of tropical medicine is pretty much non existence but I wonder what kind of work up has been done in the past? Any kind of skin biopsy or stool sample to look for parasite? I agree that cortisone shot on a regular basis is one of the least desirable way to go.
If you have not already try, may be a university hospital might be better than private clinic for something usual and rare like this since they tend to have more staffs who has some training from abroad who may have seen more tropical diseases than doctors trained only in the US or at least has a bit more experience about some of the more unusal infection.
Alternatively, travel to Hondurus might be just a coincidence. A number of other systemic diseases, autoimmune, allergy, even malignancy may also cause some kind of rahses. So I would not just concentrate on the travel history alone. Since it has been a year, I assume that your internist probably have looked into other possibility as well. I guess without knowing more detail, it would be hard to narrow it down especially without having actually seeing it.
Just a thought.

 

[Bonnet Ray]

Stress can also cause rashes so you might want to look at a broader cause for the rash.

I've had several rashes from allegies and found that calamine lotion really helped and is less invasive than jabs.

I hope you find the cause soon

 

[SubQ]

Hi diveluv,

Sorry to hear about your husbands' problems. I have no real medical knowledge, but two possibilities sprang to mind that I'd thought I could mention. I thought about an amoebal infection. A friend of mine had stabbing pains in his side in Honduras, diving off Utila, and I know from other Utila divers that this is a common problem there. About the rash, I don't know, honestly I thought about a lymphoma, but hey that may be just a mind prejudiced by personal experience. I agree with ssra 30 though; the travel may be just a coincidence.

I wish you all the best and good luck with figuring this out and getting rid of it.

SubQ

 

[Laurence Stein DDS]

Diveluv,

Do your husband's doctors suspect an infectious agent or has one been ruled out?

To be on monthly doses of cortisone for an infectious agent could be a problem.

It would be normal for a dematologist to suspect an allergic reaction but at one year, and with no results, IMHO, he's not having an allergic reaction to an insect sting, coral sting or deet. You have removed the potential insult long ago.

Ssra30 could also be correct when she said that the travel and the problem are actually unrelated. You would then have to have a complete work up.

On the otherhand, if it is an infective agent, then the first thing you want to establish is a diagnosis. There are several ways to at least narrow down the list and distinguish infective agents.

You might want to check with an Infectious Disease specialist, an M.D. Find one with experience with tropical diseases.

The side effects of cortisone are nothing to be messed with. The drug may help allergic/inflammatory conditions but it may be contraindicated in infections. It supresses the immune response to the agent and it allows the agent to become more established.

This is way beyond my professional knowledge so just treat this as any other "lay" response.

Hope he feels better soon.

Larry Stein