[78F] Experiencing a range of symptoms post-travel

Patient Description

A 78-year-old female presents with a variety of symptoms that started after a trip, including a persistent leg sore that initially caused sharp pain but now results in dull pain and has not healed for several months. The sore is aggravated by clothing rubbing against it, and treatments such as honey, silverdone, Dakin mixture, iodine medicine, and different bandages have been tried, with Dakin being the most effective. Additionally, the patient reports low-grade fevers at night, feeling fine during the day, and has tested negative for Covid recently. The patient also experiences headaches upon waking, rated 3/10 for pain, described more as confusion rather than an ache, and sometimes accompanied by dizziness. The patient's medical history was not provided, and there was no further information on the blurred vision or other symptoms mentioned.

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Arora's Assessment

What might be happening

Based on the information provided, here are some possibilities:

  • Coccidioidomycosis (Valley Fever): This is an infection caused by the fungus Coccidioides immitis, which you mentioned was cultured from your leg sore. This fungus is found in soil in specific parts of the U.S. and people get infected by inhaling the fungal spores. Symptoms can range from mild (flu-like symptoms, rash) to severe (chronic pneumonia, disseminated disease). Given your symptoms of fever, body aches, weight loss, and confusion, and the fact that your leg sore was cultured as Coccidioides immitis, this could be a possibility.

    • Treatment typically involves antifungal medications, which can be taken for several months. In severe cases, hospitalization may be required.
  • Neurological conditions: Your symptoms of headache, blurred vision, and confusion could be due to a variety of neurological conditions. These could range from migraines to more serious conditions like a brain tumor or stroke. However, since your CT scan was clear, serious conditions are less likely.

    • Treatment would depend on the specific condition and could range from lifestyle changes and medications to surgery in some cases.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms and medical history in person.

What you can do

  1. Continue with your wound clinic appointments. They can monitor the progress of your leg sore and adjust treatment as necessary.
  2. Stay hydrated and eat a balanced diet. This can help your body fight off infections and recover faster.
  3. Rest as much as possible. This can also help your body recover.
  4. Keep a symptom diary. Note down when your symptoms occur, how severe they are, and anything that makes them better or worse. This can be helpful information for your doctor.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe headache or a headache that is getting progressively worse
  • Sudden onset of severe confusion or difficulty speaking
  • Sudden vision changes or loss of vision
  • Difficulty breathing or shortness of breath
  • Chest pain
  • Severe abdominal pain

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

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People Also Ask


What is Coccidioidomycosis and how is it treated?

Coccidioidomycosis, also known as Valley Fever, is an infection caused by the fungus Coccidioides immitis, found in soil in certain areas. It is treated with antifungal medications, which may need to be taken for several months, and in severe cases, hospitalization might be required.


Why might a leg sore not heal for several months?

A leg sore might not heal for several months due to factors like poor circulation, infection, underlying medical conditions such as diabetes, or inadequate wound care. Persistent sores should be evaluated by a healthcare professional.


What could cause headaches and confusion upon waking?

Headaches and confusion upon waking could be due to various neurological conditions, sleep disorders, or even dehydration. Since serious conditions are less likely with a clear CT scan, other causes like migraines or sleep apnea might be considered.


What are the signs that a persistent sore might be infected?

Signs that a persistent sore might be infected include increased redness, swelling, warmth around the sore, pus or drainage, a foul odor, and increased pain. Fever and feeling unwell can also indicate infection.


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