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My friend is working in Frankfurt Germany and has been

Customer Question
My friend is working...

My friend is working in Frankfurt Germany and has been having reoccurring bouts of weakness,fever and loss of apetite. He thinks its Malaria but the ridk of that is low for Germany. He says there has been no abdominal pain, diarrhea or jaundice. I was concerned about Hep A or leptospirosis. Any ideas of possible causes? Trying to get him to go to a clinic but might be difficult because of need for upfront payment. He has been running himself down with long hours, lack of sleep and stress, but the reoccurring fever is concerning me

Doctor's Assistant: How long have you had a fever? Do you have any respiratory symptoms?

He's been complaining about the fever on and off for a little over a month now. He takes a day off to rest and does better but he has been having days of fever and weakness about once a week

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

He left LA the end of June and has been working remodeling a private library in the area. I've asked him s lot of questions and he says those are the only symptoms. There was quite a bit of rain and a little flooding last month. He works with laborers that includes refugees in the ares

Submitted: 9 months ago.Category: Medical
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Answered in 5 minutes by:
9/25/2017
Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,459
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

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Customer reply replied 9 months ago
Thank you
Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

Working with laborers and refugees indicates that this is likely to be a chronic infection. It is difficult to make any guess as only investigative work can point to the cause. These symptoms and manifestations do not point to Hepatitis A or leptospirosis. He may need a prolonged course of antibiotic. Following investigations are recommended;

1) Obtain cultures for bacteria, mycobacteria, and fungi (blood, urine, stool, sputum, spinal fluid).

2) Serologies for Brucellosis, CMV infection, amebiasis, toxoplasmosis, and chlamydial diseases.

3) Serum protein electrophoresis (SPEP) is useful in diagnosing atrial myxoma, SLE flares, and lymphomas.

4) Serum ferritin levels are useful in cases of malignancies, SLE flare, and adult Still disease.

5) Antinuclear antibody titers, rheumatologic factor, thyroxine level, and ESR,

6) High resolution CT scan of lung and CT scan of chest.

7) Ultrasound and CT scan of abdomen.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

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