Dr. Shubadeep Debabrata Sinha
Infectious Diseases
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I need help badly. I am concerned I have some infection. My WBC are 3.7. It did not drop that low until I moved into an area that has environmental issues. I do not know how to express this. I have headaches, nausea, vomiting, fatigue, and rashes, but I do not know what is more disturbing.
Hi,
Welcome to icliniq.com.
Thanks for your query.
At the outset, I feel sorry for your predicament for the lack of attention. Based on your reports (attachments removed to protect the patient's identity), it does not appear to be an emergency condition; hence the ER may not be helping much. However, there is a definite reduction in your WBC counts (as mentioned by you and as per reports shared). However, it is still 'clinically not significant.' In case of systemic septic or infective situation, the WBC counts should increase in response to the infection. The differential WBC counts have not changed, which can be considered 'clinically significant.' What is needed to further comment is your entire clinical records of the hospital are scanned and shared. Also, I will need to know the family medical history to understand any similar history or any related clinical history in any family members. Who diagnosed skin lesions shown in the photograph as fungal lesions? Is it a past clinical history, or is it your diagnosis? The lesions appear to be that of dermatophytosis or superficial skin lesions, with no systemic involvement and no hematological involvement.
Please revert so that we could discuss further and sort the issue.
Patient's Query
Hi doctor,
The situation is this. I got sick shortly after I moved into my father's home. I noticed I was having a lot of the same symptoms. His home was just inspected and confirmed an unusual presence of growing Stachybotrys in his ceiling. I moved from his home to my house. I noticed I only feel ill inside that home. I got it inspected, the test confirmed over 19 different fungi or organic growth in the air and HVAC system. Not necessarily too high levels, but the fact that it was in the HVAC system made me ill all over again but now worse. I am experiencing a blockage in my airways. The only thing I can consume is hot tea. Even water gets stuck. They claim what I have is not common in my country. I constantly have itching, nausea, vomiting, headache, stomach pain, earache, and pain in my lungs area. An urgent care doctor said he saw a lot of fluid in my ears yesterday. The doctor diagnosed it as tinea corpus. That is only closest to a diagnosis. He suspected other things but cannot interpret that, considering I will need to have a biopsy. His report said I looked normal, but the pictures I sent you is far from normal. I do not have a family history of any of this. However, my father just passed away from very similar issues. I did not know he was living in such conditions until we got there to help him. The septic tank was seven years overdue and close to bathroom windows. The odor reeked throughout the home. Just early last year, before he fell ill, all of a sudden, he put a brand new roof on the old house. Encasing the already moldy ceiling, months later, he fell sick drastically.
And diagnosis with stage 4 lung cancer. The week he passed away, they attempted several lumbar punctures but were unsuccessful. Ultimately died of septic shock and post obstructive pneumonia (no autopsy). I know what I am experiencing is environmental. All three of my kids are experiencing the same. I am trying to be as detailed as possible. I was never diagnosed with any breathing issues. Every time I see a doctor, they do simple blood work and say I am fine. I am HIV negative also. I have type 2 diabetes, controlled. I have taken no drugs ever and no alcohol for two years. I have added some pictures.
Hi,
Welcome back to icliniq.com.
Thanks for your detailed write-up and photographs. (attachment removed to protect the patient's identity). What I could fathom were as follows-
1. Your doctor diagnosed your lesions as Tinea corporis. I would like to see the clinical papers. Tinea corporis is a dermatophytosis (superficial fungal infection) of the whole body. And is a common dermal fungal disease related to sanitation and hygiene issues. The treatment is both topical (locally applied), e. g., Clotrimazole (local application), and systemic (oral) antifungals. The doctor must have prescribed these. If not, please let me know.
2. Your father had stage 4 lung cancer and had an unfortunate demise due to septic shock and obstructive pneumonia, as per your writeup. That has nothing to do with your skin ailment.
3. You suspect mold infestation in your roof and HVAC (heating, ventilation, and air conditioning), which you think is the reason for your issues. There is nothing clinically I can do about it, except requesting you to get the same checked by respective experts.
Please let me know any history and clinical records of the fungal affliction of the mouth or lungs. If so, please share. You mentioned that your children are also apparently affected by a skin infection. They are probably similar dermatophytosis Tinea infection, passed on from you or friends or family. If there are any clinical records of their treatment, please let me know.
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