I am the parasite who travels two by two.

July 30, 2013 9:31 AM

I've been experiencing fairly serious joint pain since returning from a Central & South American trip, and so has my travel buddy. Doctor found "many Blastocystis Hominis" in my stool sample. Normally doctors don't treat Blastocystosis, and it is usually more linked with GI issues than joint pain. Doctor has given me the option to a) Get medical treatment (that he will prescribe) or b) Wait for an appointment with a tropical medicine specialist (not until late August). YANMD, but what should I do here?

I'm a 27 year old female, no previous history of joint pain. This has been going on for at least a month now. It affects various joints, although mostly knees, ankles and hips, and the pain varies depending on the day (or even time of day) and moves around to different joints. It's bad; hard to sleep, stand for long periods of time, sit comfortably, etc. I can't exercise and even yoga is out depending on how badly I'm hurting that day.

My doctor (from a drop-in clinic) was initially concerned about rheumatoid arthritis or something else autoimmune, because I have a high incidence of canker sores. However, his opinion changed when I found out that my travel buddy also had the joint pain issue (we travelled to Bolivia, Argentina and Chile together, and previously I was living in rural Central America).

I just got the parasite results this morning, and my doctor really wasn't sure whether to treat the protozoa or not. Official medical opinion tends toward not treating, but he said he usually errs on the side of giving medication in these cases, even though it's an "off the book" cure. It's tricky because my symptoms are not the common symptoms of B. Hominis (although I had GI issues during travel, that cleared up very quickly). He asked me to come in with more samples to double check, and gave me the choice to decide. Previously he referred me to a tropical medical specialist while all of the tests were in progress, but that appointment isn't for over two weeks.

So, should I treat this or not? I want this arthritic nonsense to go away. I'm leaning toward treating, because if it doesn't clear up in two weeks, at least I have some more material to present the tropical medicine folk with. Although obviously being on heavy medication unnecessarily is not ideal.

posted by Paper rabies to Health & Fitness (8 answers total)

I know your appointment isn't for two weeks, but could you call the specialist and see if they can either tell you to wait or to take the meds in the interim or move you up (possibly into a cancellation)?
posted by vegartanipla at 9:37 AM on July 30, 2013 [1 favorite]

Best answer: I'm sort of with you on this. If you can tough it out until you get to the specialist, I'd do that. But call their office and let them know that you have the test results back and ask if they think you should try something in the interim, or if you can move your appointment up.

I find that the nurses in doctors offices are knowledgable and helpful in these instances.
posted by Ruthless Bunny at 9:47 AM on July 30, 2013 [2 favorites]

Yes, call the specialist's office. As long as you can get past the front desk admin to someone who has medical training, you should be able to get an informed opinion on whether you should start the medication right away or wait.

Also, what vegartanipla and Ruthless Bunny said about checking for earlier openings.
posted by RedOrGreen at 10:08 AM on July 30, 2013

I would be calling the specialist, yes. As RedOrGreen says, if you can get past the gatekeeper on the phone, you might be able to get some advice on how to proceed, or they may be willing to consult with your doctor at least.

Google turns up this article. So, from that, it looks (and I am not a doctor of course) like Blastocystis hominis causing joint paint is very rare, but it has happened at least once.
posted by gudrun at 10:18 AM on July 30, 2013

Response by poster: I called the specialist's office and managed to get my appointment bumped up a week, but it turned out that it was originally booked later than I realized... so it's still a two week wait. No doctor in the office today so I could only consult with the secretary.
posted by Paper rabies at 11:17 AM on July 30, 2013

Just keep being persistent, call back once a day and check in on the cancellation list and try to consult with a nurse. You'll get an answer sooner or later and hopefully get your appointment bumped up.
posted by timpanogos at 12:22 PM on July 30, 2013 [1 favorite]

I would opt to get treated ASAP, since joint damage is cumulative. The more quickly you can stop the infection, the better.
posted by gjc at 2:49 PM on July 30, 2013 [1 favorite]

Response by poster: Update:

I was planning to wait until my appointment to take the antibiotics, but then I (fortuitously?) ended up getting a major throat/sinus infection. So, my doctor gave me meds that would kill both the infection and the parasite.

Shortly after that I had my specialist appointment. The tropical medicine folks didn't think that parasite would have been causing the pain, nor did they have a good idea of what could be doing so. But they also prescribed me a treatment for pinworm (I guess I was collecting parasites).

And now, a few weeks later, my joints are feeling good and I'm running again! I don't know whether it was the treatment(s) or just the symptoms naturally clearing up, but I'm happy either way.
posted by Paper rabies at 12:30 PM on August 29, 2013