Dear Ask The Doctor: Five of my friends and I went on a trip to Tennessee Mountains, where we were in the woods a bit, as well as in using the same hot tube for about 6 days. We all ate mostly the same foods, drink, etc. Two of the five of us have no symptoms at all. One day after returning, three of us have swollen axillary lymph nodes, headaches, joint pains, fever (not in all three of us). The lymph node swelling follows down the lymph track in two of us, extending into the chest. Two of us have swollen lymph nodes all the way into our chests, under the nipples. There are no noted target lesions, no known tick bites, no nausea, vomiting or GI complaints thus far. Two of the three of us have upper respiratory complaints as well. What kind of communicable disease presents in this fashion? Two of us are on Doxycycline 100mg twice a day, with no decrease in symptoms thus far. One male and two females. Is it bacterial? Is it viral? Could it be fungal? What else should I look for? What else should be done?
Dear Ko: From your description of the location, it seems that you all might have inhaled a type of fungus or its spores found in soil and wood, known as Blastomyces Dermatitidis. Breathing of this fungus usually leads to Blastomycosis or Gilchrist’s Disease and it is not a communicable disease that spreads from person to person. Seeking immediate treatment is important for the prevention of life threatening complications including severe lung infections, abscess, breathing difficulty etc. Treatment with anti fungal antibiotics like ketoconazole, amphotericin B, fluconazole etc. may be required for fast recovery.