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Visited camel farm and developed difficulty breathing

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Hello,

I am 23 years old.
I visited Saudi Arabia recently for two weeks. There I visited a camel farm (MERS?) on the second or third day. I also went to the fitness center during the first week of my stay and did some extensive jogging. The air conditioners there were freezing, as well the ones in the office, were I wore a jacket because I could not stand the cold air. In the second week I developed breathing difficulties, meaning I breath very hard but I still don't have the feeling my lung gets a lot of air. This usually only occured in the evening/nighttime, during the day I could work without any problems. After a few days, I also became dizzy when I had to get up quickly or had to run for a short period of time. Plus the back of my chest and my kidneys hurt every now and then for a few mins.

I returned this friday. On my flight home (8 hours) I slept the first 6 hours. After waking up I felt terribly cold, even though I was wearing a jacket and a blanket. After leaving the plane I felt fine again, no signs of fever when I measured my temperatur at home (But maybe in the plane?). The next day (Saturday) I had 36,9 centigrades for about 5-10mins at night/evening. After that my temp got lower again. I usually feel dizzy now during nighttime, but I have no problems sleeping. Usually when I lie down flat at night, I can breath easily as I would normally. I thought the sinuses were congested, but then I inhaled hot saltwater today for a few minutes and it didn't help.


I also have slight diarrhea, but usually my stool is normal.

I now have this condition since 7 or 8 days, and it didn't really get worse, only a tiny bit. Did I just get a cold from air conditioners? Or might I have MERS? The WHO page suggest consulting a doctor when having breathing difficulties. If I had MERS since 8 days, wouldn't I be a total wreck and have terrible symptoms like high fever and coughing? BTW, I don't cough at all.

Thanks and best regards,
Peter

Category: Family Physician-GP

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Category: Family Physician-GP
 18 Doctors Online

Hello,

Thank you for asking your query at DoctorSpring.

Could you please clarify on these points.

1. Are having breathlessness only when you lie down ?
2. Do you have breathlessness with mild - moderate exercise ? Like from climbing a flight of stairs ?
3. Can I say that your only symptoms NOW are breathlessness on lying down and mild diarrhoea ?

You can reply as a followup query.
Thank you


Patient replied :

Dear Dr. Deepu Sebin Sebastian,

1. Sorry, I think I didn't express myself properly. Breathlessness _goes away_ when I lie down at night . Then I have the feeling to be able to breath properly again. When I move a bit, eg turn to left or right side, it worsens.

2. No, not really, I can run up or down the stairs I guess and move around outside freely. Though only for one floor, I didn't try to climb more floors.

3. Yes exactly, I breath very hard but can make it a bit better when I sit down and take my time. Very mild diarrhoea I would say, very little amounts of fluid stool. Int he morning it is perfectly normal. My lungs hurts a bit, it's a slight feeling of burning in the front. But I am not sure anymore because I might by hypochondriac due to my internet research.

Could it be that I don't have the typical MERS symptoms and my lungs deteriorate?

Thanks,
Peter


Hello Peter,

Thank you for the detailed information.

Your symptoms and the pattern of evolution of the symptoms are NOT suggestive of MERS. I hope you would understand the symptom based analysis has its own limitations.

These are the points against a possible MERS

1. Absence of typical symptom set. From the available cases reports (also In some other Corona virus infections) fever and cough are predominant symptoms along with breathlessness.
2. MERS is not known to be as contagious as other Corona virus ( Close personal contact with patient is presumed mode of transmission – There is some lack of clarity in this, but still )
3. No evolution of the symptoms or no development of complications within this time period.

This could be still a viral infection (as in a flu). This could explain the minimal cough, the aches, and the diarrhoea. Am not quite sure about the breathlessness. Since you are completely ok with exertion , probably this is bit anxiety related. Anyway if you have access to medical care, I do recommend and GP consult and a Chest Xray (if needed after assessment by your Doctor). Otherwise you can observe for a couple more days and if the symptoms persists / worsens you can visit the ER / medical help.

Hope this helps
Please feel free to ask followup questions.


Patient replied :

Thanks for the fast reply.

I started to cough a few hours ago with a chest burn. Might that just be a Bronchitis from the air conditioners? Would that also explain the chest burn? I do not really file like a have a flu, e.g. I can normally do a normal activity. No running nose, no cough, no red eyes.

I also do not a lot of expectoration, only sometimes transparent one from a cough.

I will visit a doctor tomorrow.


I read a lot about MERS on the internet (what a mistake) and basically it all starts with something like a pneumonia or a lower chest infection. Wouldn't bronchitis be also the first stage then?

Would you consider it unrealistic to have MERS and still feel good after the first signs of breathing difficulty (7-8 days ago)?

I have absolutely no clue of incubation of viruses, but wouldn't I have much rather have at first a kind of flu with fever, then breathing difficulty due to the pneumonia and then I would feel terrible and would have to go to a hospital as well?

I also was in close contact to 3 people in Saudi Arabia (one of them being my girlfriend). She is perfectly fine healthwise, does that mean it is unlikely that I have MERS?

Best regards,
Peter



Hello Peter,

1. Yes the cough could be the bronchitis from a viral infection or an allergic reaction to exposure to cold.). The chest burn is probably unrelated due some acid regurgitation. Cough can also cause reflux acid regurgitation. This is should resolve by itself under normal circumstances.
2. Bronchitis won’t be the first stage in most cases.
3. I would not consider it unrealistic, but it is less likely. A mild infection could present like this. You should understand this is a new outbreak and only limited research and information is available at this time.
4.Yes you are right – typically the breathlessness follows fever and cough. That’s why it is unlikely in your case.
5. Yes, the fact that your contacts (your girlfriend) is healthy also suggest this is possibly not MERS.

----
“When I breath really deeply my chest also burns a little in the nipple-area. Sometimes I can also hear some sort of movement (audible as squeaking) my right lower chest (front). That is quite weird.
Very seldem I have some sort of heartburn (for about 1-2 mins, I had this the first time yesterday). “
--
The squeakiness suggest a small airway obstruction probably form mucous or secretion. It’s a good thing that you are visiting your Doctor. Do mention your travel history. You need not worry about the heartburn now as it should resolve once the cough resolves. Avoid spicy and irritant food for the time being

Hope this helps
Thank you.


Patient replied :

When I drink orange juice or something like that, my upper lung area starts to burn. Also, after eating some spicy stuff, my whole throat and upper lung burns. Does that make sense?

Actually, do you think that might just be a pleuritis with bronchitis?

That makes totally sense, because I hear this sort of squeaking when I breath in, which is common for pleuritis. Plus this breathing difficulties because the lung cannot properly unfold itself?

Isn't pleuritis quite common with bronchitis? At least that would make sense now.

For instance, I worked out hard and sat 1 hour in front of the computer full of sweat without taking a shower first (in Saudi last week). Air conditioners were on. It's also the neck muscles that hurt a bit for instance.


The condition worsened to be honest, as I didn't have bronchitis or chest burn before. The breathing difficulty might have gotten worse a tad too. But within 7 or 8 days of MERS infection I would probably not be able to sit in front of my PC most likely, isn't it?

In a mild MERS case, might it just behave like regular Coronavirus? At least I read about young people getting MERS (hospital workers) and all of them could be healed easily.


Hello,
Its not the lungs, its the esophagus (food pipe) that's giving the burning feeling. Avoid food items which you think is precipitating it. Again this is unrelated and no need to worry

Well, you have more respiratory symptoms now, than you have mentioned in your first (original ) consult. Still it is bit non specific. Pleuritis is less likely. A mucus plug / secretion is the most common cause for the squeaky sound. No pleuritis is not common with bronchitis. Yes - Mild cases of MERS could be just like any other respiratory viral illness.

There is no alarming symptoms as of now. But do consult your Doctor as soon as possible

Hope this helps.
Thank you


Dr. Mayank Bhargava
Category: Family Physician-GP
Experience: 
Fellowship: Gastroenterology, Chotiram Hospital & Research centre, Indore, 2009
Residency: General Medicine, Rajasthan University Jaipur, 2008
Medical School:  MBBS, Rajasthan University Jaipur, 2004
Dr. Mayank Bhargava and 4 other Medical Specialists are ready to help you

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