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Respiratory: Allergies & Sinus Problems/Poteintial allergy, or response to infectious disease?

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Question
Hi Gene,

I'm not sure that I have the right category for my question, but here is my story.

I have recently returned from a two week trip to South East Asia (returned 6 days ago). During the trip I had bouts of gastro-type symptoms (diarrhea and stomach bloating, but no vomiting), and towards the end of the trip I felt as though I had a minor flu or cold. On the last day of the trip (approx. Dec 29 2012), I developed minor itches in localized areas of the calves of my legs and in the genital region (particularly at the base of the scrotum). Over the subsequent days the itching became worse, and a rash appeared, most prominently over the genitals but some also on my legs and some on my chest.  

Yesterday (Jan 3 2013) I woke up with what appeared (to me) like a moderate allergic reaction. My face very red and my ears were burning, my eyelids were puffed and my eyes were watery and irritated, and additionally, the rash over my genitals appeared to be worse and the skin of the genitals was somewhat inflamed. I went to the doctor to be checked out. After telling her my story, she though it might be measles, but I pointed out that I have had the MMR vaccine. She then suggested it could be typhoid due to the rash I had developed. Whatever the case, she ordered me to provide stool samples to be examined, and ordered the following tests:

FBE (blood test), dengue, filariasis, plague, and LFTS (liver function).

The stool samples are to be taken on separate days, and I'm undertaking that process. In the meantime, the doctor recommended taking cetirizine when needed.  

This morning (Jan 4, 2013) when I woke up, the allergy symptoms had improved somewhat. The itchiness was still there (particularly the genitals), but the redness in my face and the puffy eyelids had abated a little. Redness/rash was still prominent in the genital region, and still present on the legs and chest. I took 10 mg cetirizine, and the itchiness improved over time, but the redness is still there.  

In general, it is the doctor's opinion that the allergy-type symptoms are a result of an underlying infection producing an inflammatory response. It may be the case, but I have also been exposed to a range of foods/detergents/pollutants which might have resulted in an allergic reaction, and the diarrheal component to my symptoms could be a completely separate issue.

Would you be able to comment on the tests, potential causes of my symptoms, and future treatments? It seemed to me as though the doctor wasn't particularly confident or committed to any diagnosis.  

Thank-you for your time and expertise!

NB: Additional information - I didn't engage in any risky behavior, such as drug taking or casual relations during the trip!

Answer
JC...

One cannot have full confidence with these types of issues. You had so many skin reactions linking to the bowel that I think her original tests were most appropriate.

I might suggest that you await the results and then seek out a good infectious disease physician.

Overlying sypmtoms are tough to unmask.

Cheers, Gene

Respiratory: Allergies & Sinus Problems

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Gene Sperling

Expertise

I can answer questions about indoor air quality, respiratory medications, home toxins, allergies and VOC's (volatile organic compounds). Home and office environmental issues and general medication questions regarding side effects and interactions.

Experience

I have been a pharmacist for 30 years. I have been director of pharmacy services for a large teaching hospital, and have served as a consultant pharmacist to various out-patient programs. I have organized and managed various infusion programs treating infectious disease, immunologic diseases, and metabolic disorders. For the past 15 years I have operated a national respiratory pharmacy and devoted my time to assessing asthma, COPD, and emphysema patients and their problems. I know how to set-up and maintain a 'clean room' environment and I know how to resourcefully remediate environmental issues that cause health problems.

Organizations
I am a current or past member of IAQA, IESO, CA Pharmacists Assoc., NCPA, Consultant Pharmacists Assoc., Calcerts, and many others. I have licensing from the GSA (Government Services Organization). I have served on the California Task Force for Disaster Preparedness under the Department of Health Services.

Publications
I am in the process of researching the application of Building Science as it relates to the Healthcare Industry. The purpose is to show the relationship(s) between 'sealed environments', poor construction, and improper equipment installations in modern homes and offices. The building boom of the 90's and 00's accelerated at a pace that did not allow proper oversight or adequate research of new techniques in construction design and the trades that applied them.

Education/Credentials
I have a degree in Pharmacy from the University of Oklahoma. I have upper division courses in bio-pharmaceutics, medicinal chemistry, organic chemistry, pharmacokinetics, toxicology, immunology, microbiology,etc. I have taken numerous post-graduate courses on respiratory disorders, mold, environmental issues, indoor air quality, building science, HVAC, clean room set-ups, womens health, and medication therapy management.

Awards and Honors
I have received a distinguished achievement award from the County of Los Angeles for work with the Asthma Reading & Education Program sponsered by the UCLA clinics and Martin Luther King Medical Center. I have sponsored winter ski retreats for children with asthma. I have served on the Boards of several home health agencies. My highest honor comes when I can help someone understand how their personal environment influences their health, and how their own awareness positively impacts their quality of living. There is no greater award than helping others.

Past/Present Clients
My past and current clients have been the thousands of patients and physicians that I have consulted for and with to assess alternative approaches to disease management through common sense treatment, and how our personal environment influences our overall health.

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