Medical diagnosis question...

[horseshowmom]

DD is a college freshman. Wednedsday afternoon she started to feel bad (after being fine all day). Very shortly, she began running a fever (which is very unusual - she almost never runs a fever and hasn't had one since she had the flu two years ago) and began to feel awful. Her symptoms were identical (up to that point) to when she had the flu.

I carried her to our nurse practitioner Thursday morning (she's very conscientious, and we really like her). The nose swab flu test came back negative. The NP said that her stomach (bowels?) sounded abnormally active. She said that DD had something viral going on, probably the stomach flu (although DD didn't have diarrhea and had only vomited once and very little at that). She prescribed Phenergan gel on an as needed basis.

Fever went down last night with meds, and she hasn't needed the Phenergan at all (no vomiting or diarrhea at all). Today, the fever is back up (to over 102), and the inside of her mouth is covered in ulcers (20 or 25 at least).

I'm at a loss and have never seen anything like this, but I don't think it's the stomach flu. Now it's Friday afternoon, and I don't know if I need to be worried or not.

Can anybody tell me whether you've had or seen these symptoms?

 

[bellacam]

There is an occurance of Menengitis going on at our local college campus. I am not familiar with the sypmtoms but I understand it is common on campuses. Have your daughter tested for it. The ulcers can also be caused by a high fever.

 

[hydster]

Could be strep *I had it last week with no sore throat but with canker sores and a fever* or maybe mono?

I sure hope she feels better soon.

 

[horseshowmom]

bellacam, at your suggestion I checked the symptoms of menengitis. While she does have a couple of the same symptoms (enough to make me nervous), she doesn't have the major ones (except the fever). If this continues through tomorrow, I may take her and have her tested.

hydster, like you, she doesn't have a sore throat (wasn't red at the doctor's office), but you never know. I've known others who had strep and didn't have a sore throat.

Thanks!

 

[jel0511]

i'd have her checked for strep. DD was running a fever for 4 days and nothing else was wrong, Dr ran strsp test, positive. never complained about her throat.

 

[RachelEllen]

Hi,

I usually hesitate to offer diagnoses over the internet, but as long as you understand this is in no way official.....

It really sounds like herpangina. That's a pretty begign viral infection that makes you feel just awful. Certainly discuss mengingitis with her NP. I'm sure they will check her for signs. But the 'test' is a spinal tap, so it's not really done without good cause. I bet if you return with those blisters you'll get this diagnosis (or one of 'coxsackie virus' - the most common cause).

Here's a physician oriented article on herpangina: http://www.emedicine.com/med/topic1004.htm

I'm sure there are more patient centered resources out there as well.

We see this all the time in pediatrics!

hth,

Rachel

 

[horseshowmom]

RachelEllen,

She's got a sore throat now but not a bad one (said she just notices it when she swallows). The other stuff does sound like what she has (I never even heard of it before). It doesn't sound like there's much you can do about it other than wait it out. The NP had said she was sure it was viral. She's still at 100.5 even with Tylenol.

I called the NP when I found out about the ulcers in her mouth (DH stayed with her today while I went in to work, so I didn't know about them until lunch). She called in a prescription for Alpharma (swish it in your mouth and then swallow it).

This is the third day with fever. If it should turn out to be herpangina, how long does it usually last? DD is an early entry pharmacy student, and her classes are pretty tough. She's already missed two days of class.

 

[horseshowmom]

I did some more research, and this really does sound exactly like what she has (including the sore throat). It said that it could last 3 - 6 days. I'm hoping she can get back to class on Monday.

Thanks so much for the information (and I definitely recognize that it's unofficial!). I feel much better (hopefully, she will too before long)!

 

[RachelEllen]

No problem. And I hope she feels better soon!

 

[luvmydogs]

My ds10 had bacterial meningitis when he was three. Misdiagnosed for two weeks, and unconcious by the time he was hospitalized. He had to have a spinal tap to be tested--spinal fluid was cloudy, which=infection and meningitis diagnosis. Vomitting (he went from 40 to 29 pounds), immobile neck, unbelievably painful headache and no dialation of pupils with light source/light sensitivity as the symptoms. Never once did he have a sore in his mouth or sore throat, and they are not normally symptoms. Bacterial meningitis is potentially fatal, always serious (viral meningitis makes you very ill, but recovery almost guarenteed), rare, but can be highly contagious. Ds was quarrantined, and dh and I treated prophylactically.

Certainly not diagnosing her, but I wouldn't worry about it being meningitis, but as always would encourage you to talk to her doctor. I hope she's better soon!

 

[horseshowmom]

luvmydogs, thanks! I did feel better after looking at the symptoms. We discussed the menengitis shot before she started college, but they recommend it if you live in the dorms. She commutes and has a major thing about shots, so I didn't force the issue. I was starting to wish I'd made her take it.

RachelEllen, this is her fifth day with fever, but today it's down to 99.7 (which is certainly an improvement), and she feels a lot better.

We're wondering how long she's contagious. She really needs to get back to school (has a test tomorrow).


Thanks!

 

[luvmydogs]

I'm so glad to hear your dd's fever is going down and she's feeling better--those definitely are good signs! Do you believe that it was something viral?

Best wishes to her, and hopefully you and your family stay healthy!

Oh, and as for the meningitis shot--when the time comes, MY SON IS GETTING ONE!!! I'm not going through that again!

 

[Nana Annie]

Putting my flame suit on here, but is there a reason she has gone 5 days with a fever and has not seen her doctor? Not placing any blame on you, but a NP (or a PA, or a MD) that does prescriptions over the phone based on descriptions of new symptoms, without seeing the patient again, would make me very nervous.

Seeing the doctor can never hurt and can ease your mind on what it could or could not be. Especially if she needs to get back to school. AND the MD would know if she is contagious and could safely return to school without infecting the rest of the class.

I wouldn't put my trust in the internet and DIS boards for health issues, as they are no substitute for a medical license

Hope she feels better soon!

 

[BibbidiBobbidiBOO]

We discussed the menengitis shot before she started college, but they recommend it if you live in the dorms.

Actually they recommend it before High School now. My DS got on a list for Menactra vaccine and received it last fall. He was 14. CDC recommends at 11-12.
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm#Are there vaccines against meningitis

Glad she is feeling better. Sounds viral to me.

 

[Tanuki]

The rapid flu tests that can be done in a doctors office aren't all that accurate. It's basically the same as tossing a coin.

So it is entirely possible that even with a negative test she could still have the flu. Not that there is any particular treatment for it.

But if you have fever you ought to come in to be rechecked about every 3 days. Sooner if your symptoms change significantly. Because things can change during the course of a viral illness. Sometimes later in the course of a virus a secondary bacterial infection can set in.

 

[HOGFAN]

get a blood test for mono

 

[horseshowmom]

Putting my flame suit on here, but is there a reason she has gone 5 days with a fever and has not seen her doctor? Not placing any blame on you, but a NP (or a PA, or a MD) that does prescriptions over the phone based on descriptions of new symptoms, without seeing the patient again, would make me very nervous.

Seeing the doctor can never hurt and can ease your mind on what it could or could not be. Especially if she needs to get back to school. AND the MD would know if she is contagious and could safely return to school without infecting the rest of the class.

I wouldn't put my trust in the internet and DIS boards for health issues, as they are no substitute for a medical license

Hope she feels better soon!

No flames here. I assure you that I'm particular enough about my DD that I'm not offended at all.

We had seen the NP (who was positive it was something viral) on Thursday (fever started Wednesday night) and the new symptoms came on Friday. I started making a decision about what to do after the new symptoms came, because we were heading into the weekend and that severely limited my options (particularly in a very rural area like where we live).

I have absolutely no doubt that she has herpangina after doing some research on the symptoms. Her symptoms are exactly the same as herpangina (including how the fever has acted).

While I had never seen it or heard of it, I have since talked to a family member who had it last year (in fact, all five of them had it ). Apparently, it's not that uncommon at all (kind of like chicken pox - which is what it looks like inside her mouth).

She's getting better every day. I just didn't want to take a chance on her going back to school and making others sick.

Thanks to everybody!