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"My nephew went to Costa Rica, came back ill and has lost 70 pounds. What could it be? "
They want him to give a stool sample but he refuses . He has also said that when he gets a cut it bleeds a lot and is watery. they in tents while they were there and he said he did not drink the water. He still vomits could it be some sort of parasite?
I am sorry to hear about your nephew's symptoms. Given what sounds like a severe illness, I strongly encourage him to see a primary care physician for further workup, as he will need a thorough history and physical exam. Depending on these findings, he will also need referral to an infectious disease specialist. Infection in travelers is common. Certain infections are more common in tropical areas, such as in Costa Rica. Malaria and Dengue fever are both found in Costa Rica, and these can cause severe fevers and chills. Although I cannot tell the full details from your question, it sounds as if he has had persistent nausea and vomiting along with significant weight loss. Given these symptoms, it is possible he has contracted a gastrointestinal infection. Common examples include E. coli, Campylobacter, and Giardia. A typical evaluation consists of blood and stool tests. I strongly encourage you consent to the stool test, as it may not be possible to provide a diagnosis without it. His increased bleeding is also concerning for an abnormality of his platelets or clotting factors. Severe infections can cause these, and it can be a life threatening condition in some cases. Given the severity of his illness, I suggest he see both a primary care physician and an infectious disease specialist.
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