Dr. Michael Ein, MD

It sounds like you have probably had COVID BA5 the whole time you have had symptoms since you got home. The rapid COVID antigen tests usually don’t turn positive until 2-3 days after the PCR tests are positive. I don’t know why your doctor gave you Cipro for a viral infection as it will have no effect against any virus. Also, doxycycline will not affect viruses, so you should stop it. You should isolate for 5 days after your first positive antigen test and then wear a good, tight fitting N95 mask whenever in contact with other people until your antigen test turns negative which will probably occur 8-10 days after your first positive test. As you are vaccinated, boosted, are young and otherwise healthy and have had previous infection, your risk of severe disease or hospitalization is very low. Get well soon.

Your antibody tests do indicate that you have a current/recent EBV infection. You will have virus in your saliva for a prolonged period of time, average of 6 months up to 18 months of continuous viral shedding after infection then intermittent shedding for decades. Your wife may have had previous symptomatic or asymptomatic EBV infection (25-50% chance). Who have you been kissing? You may have caught it from your wife’s viral shedding. Your wife doesn’t need testing unless she becomes symptomatic.

I do not know the details or anatomy of your osteomyelitis. Usually osteomyelitis in the foot occurs in diabetics and patients with decreased peripheral blood circulation. It is usually categorized as contiguous focus osteomyelitis. This is difficult to cure without extensive surgical debridement or limited amputations. I am concerned that your infection may not have been cured if you only received antibiotic therapy. I would recommend that you see an orthopedic surgeon or podiatrist who specializes in foot infections. You probably need repeat X-rays and an MRI scan to see if you still have active infection.

It certainly looks infected. Staphylococcus aureus or Streptococcus pyogenes would be most likely pathogens but other bacteria are possible. Go to your doctor or closest emergency room immediately.

First of all, if you are afraid of getting COVID-19 you should get vaccinated and boosted with either the Pfizer or Moderna vaccines. This will decrease your risk of severe disease or death and should help assuage your fear.
You should avoid indoor gatherings with large crowds.
You should wear a properly fitting N95 mask when in doors with people, like when shopping or on public transit.
When reported cases in your area are less than 30 per 100,000 per day you can safely gather with less than 10 friends or eat at small restaurants (hopefully well ventilated).
There will always be some risk of infection but by following these guidelines your risk will be low and if you do get infected your risk of severe disease will also be low.

Ringworm is not a worm but is a superficial fungal infection. It is spread by direct contact or fomites (materials likely to carry infection, such as clothes).

To prevent ringworm:
-Do not share clothing or towels with other people.
-When at the gym, local pool, or other public areas (including the shower), always wear slippers or sandals.
-Wash thoroughly with soap and shampoo after any sport involving skin-to-skin contact.
-Avoid tight-fitting clothing. Change your socks and underwear at least once a day.
-Keep your skin clean and dry. Always dry yourself completely after bathing.
-Take your pet to the vet if it has patches of missing hair or a rash. That could be a sign of tinea infection.
-If you or someone in your family has symptoms of ringworm, make sure s/he is treated right away. Otherwise, the infection may spread.
-If you have ringworm, make sure you use the treatment for the length of time suggested. It is important to complete the full treatment course.
-If you and your cat start treatment as indicated, you properly clean and disinfect your home and you and your guests employ common sense hygiene then you can safely entertain.

My recommendation would be to forget the J&J vaccine. It has been consistently inferior to the mRNA vaccines in essentially all studies. You should take your second Moderna vaccine ASAP and 6 months afterwards take your 3rd Moderna vaccine booster.

I would get (and have gotten) both the flu and booster vaccines. Although Moderna is performing better than the other vaccines they all lose effectiveness over time. You can get both injections at the same time without increase in side effects or loss of efficacy.

Yes, you can eat and drink whatever you like after COVID vaccination.

Your stents indicate that you have coronary artery disease. This is not a contraindication for COVID vaccination. The main cardiac risk from vaccination is myocarditis that occurs mainly in young men and teenagers. The risk of myocarditis and other cardiac complications are much higher from a COVID infection. Protect yourself and your family and get vaccinated.

You have asked a very smart question. The answer isn’t easy. Your classmate is certainly at risk for catching COVID from her sister. She should be tested before being allowed back in school. If she is infected she might feel perfectly fine but still spread the virus to others. You are doing the best you can by wearing your N95 mask. Make sure it fits snugly at your nose and cheeks. Social distance and use good hand hygiene. Your risk is relatively low but unfortunately it is not zero. If you get any symptoms like having a cold or the flu, let your teacher and your parents know. Continue the smart, good job you are doing to protect your health and that of others.

Multiple anecdotal and retrospective studies have been done on the use of ivermectin in COVID-19. The results are inconclusive and meta analysis suggests there is no benefit to its use. Prospective studies are in progress but at this time infectious disease experts would not recommend the use of ivermectin for COVID.

You should see a doctor immediately. You need to receive preventative antibiotic treatment, probably with Augmentin.

There is no penicillin in any of the COVID vaccines. It’s safe for you to take it.

Hair loss has increasingly been reported in people who have recovered from COVID-19. Telogen effluvium is hair loss occurring after an episode of stress. There are many causes of hair loss including alopecia areata, hypothyroidism, iron deficiency, hyperandrogenism, autoimmune disease, chemotherapy and other medications. Get checked out by your family doctor, internist or dermatologist.

There is currently no Zika virus transmission in the USA. I would recommend that you and your daughter apply approved mosquito repellent that contains DEET or Picardin when at risk for bites. West Nile Virus, other encephalitis viruses and other diseases are spread by mosquitoes here.

The short answer is no, you should not be concerned. Dengue rarely spreads in the continental US. The rare outbreaks occur in Florida or the Gulf Coast from an imported case. These small outbreaks typically involve fewer than 50 individuals. Dengue is endemic in the US territory of Puerto Rico.

If the situation is exactly as you state, then I agree you should look for a new pediatrician. Antibiotics are generally used to treat bacterial infections. Anti-viral meds are used to treat various viral infections but not common upper respiratory infections. Unnecessary antibiotics can be expensive, cause toxicity and side effects. They can also lead to colonization and spread of antibiotic resistant bacteria.

Yes, you can get Shingles (Varicella Zoster) infection in any dermatonal distribution. L5, S1, and S2 dermatones involve the buttocks and lateral to posterior thighs.

Sounds like you have folliculitis or furunculosis. This can be treated by your family physician with hot soaks and oral antibiotics.