Consider he has cellulitis secondary to an insect or spider bite. He needs broad-spectrum IV antibiotics.

Meanwhile, if he has oral antibiotics, take them. Elevate it (higher than his heart) to minimize swelling, and apply warm, moist compresses.

Watch for swollen lymph nodes, fever, chills, sweats, drowsiness, lethargy, blistering at the site, or red streaks extending from it. Keep track of the size of the lesion. If it isn't getting smaller, he's getting in deeper and deeper trouble.

The entire episode will probably be over in seven to ten days, one way or the other.

Exactly what "tropical location" is he at? Without that information it's impossible to even guess what that bite could be. Depending on where he is, it could be a Brown Recluse bite. If so, he'll know soon enough when the entire area goes black and necrotic.

Hell, it could be topical anthrax for all we know.

If he hasn't yet seen a doctor, what is he waiting for? The leg to fall off?

http://boingboing.net/Images/sore.jpg

David is right. It's been fifteen years since I lived in the tropics, and that was the Latin American sector. There's all kinds of great stuff in Africa, Asia, wherever it's too darn hot and humid. There's no way to diagnose this over the Internet. You can't rule out spider bites, fungi, viral or bacterial infections, or parasites.

Still, elevation and warm moist heat is the general solution while going to a medic.

Any open wound in the tropics is going to get a bacterial infection sooner or later.

If I had this, I would worry.

And here's a Just For Fun: http://rob.skelly.com/index.htm

The last time I had something like that turn up on my skin, it was followed by a walloping case of Lyme Disease, a recurrence of Lyme Disease some months after the first round had supposedly been cured, a lot of down time, and joints that have never been the same since.

Here it is at one week: http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/2053.jpg

No way really to tell. Go see a medico.

Re Leishmaniasis: Ick! You're not kidding about that one being potentially devastating.

I speak as one whose parents whisked me off to an isolated backwater ashram in India. They thought it would be a cross between _Woodstock_ and _Siddhartha_, and it turned out to be more like _The Mosquito Coast_.

Back to the topic, while I was there I once got a tiny scratch which got infected and ate a hole the diameter and depth of a quarter into my thigh in a shockingly quick time. I still have a scar. And as Jim pointed out, it could have been much worse.

Cheers,
Tom

I was lucky. All it did was turn me into a superhero. Actually, it damaged the sweat glands of my right armpit, but that was all. Musta been one of the lesser nasties.

IP appears to be based on the popular Sci-Fi* card game Cosmic Encounter.

* Use deliberate.

...I just went over there and told him so. He's in the Cook Islands, which have a rich assortment of what are politely known as arthropod-borne diseases. His initial lesion seems to be healing over? Great! I'd have said exactly the same thing about the insect bite that gave me Lyme disease -- at least, until I got sick I would.

Jo: Have I confused you? I know I once told you the story about how I briefly had buboes during the worst of the Lyme disease, and Lyme and the plague are both insect-borne spirochetes; but they're not, thank god, the same disease.

This is easily sorted out: You catch Lyme disease in the Northeast. You catch the plague out West, especially in Northern Arizona and New Mexico. If promptly recognized and treated, Lyme disease can be anything from a mild and transient experience to a thoroughly miserable and insufficiently transient experience. But the plague -- famous for its 50%-90% death rate when untreated -- has a 15% death rate even when we hit it with everything in modern medicine.

Not to worry, though. The entire U.S. averages maybe a dozen cases of plague a year, almost all of them in the Four Corners area, and they're sporadic and rural. We haven't had an urban epidemic of plague since the 1920s. All you really have to remember is that the cute little rodents in the Intermountain West should be admired from a distance.

The tropics really are worse, like a permanent incubator. They have bugs there whose life cycles wouldn't be imaginable anywhere else.

Unfortunately, it isn't uncommon for Lyme disease to go unrecognized and untreated for months to years. In those cases things can get very ugly.

I do have one quibble: The death rate from plague is actually very low with prompt treatment. Less than 5%, certainly. Most deaths will be among the very young, very old, or people with compromised immune systems.

Cheers,
Tom

Tom: _Parasite Pig_ has a paperback by Penguin Firebird in the US, and I believe a copy of it is waiting for Sasha at home for Sasha to review for them. Nothing would induce me to read it, I am a squeamish grown-up in these contexts.

Sure, you can get some nasty bugs in the tropics. But malaria and yellow fever were Great American Diseases for a very long time, and were only eradicated after decades of effort, uncountable deaths and vast amounts of money. They'll probably be back some time, and they won't be any less terminal than anything you might pick up in the South Pacific, or India, or the Amazon. The reason people get sicker in tropical countries than they do in the West isn't that they're hot, or inherently malevolent; it's because tropical countries typically don't have the money for disease control programs that we do.

It's a very fun book, and it was extremely interesting seeing what got changed in the final book (including the excision of both an anecdote about shoplifting and one entire chapter about a high school teacher).

Jane

If Lyme disease were capable of being passed from person to person, rather than just by tick bites, we could have had a really ugly situation on our hands. As it was, the disease had emerged years before it was recognized; and since the first stage of the infection could mild or even asymptomatic (a lot of people thought they'd had flu), what tipped us off that we had a problem was people hitting the tertiary stage. If Lyme could pass between people, that discovery could have been on a pandemic scale.

***

CREEPY TRUE STORY ALERT

***

Karen Joy Fowler's daughter Shannon was spooning on a secluded tropical beach (in South Asia somewhere) last summer with her brand-new fiance.

Something bit him on the leg.

Three minutes later, he was dead, and Shannon was alone on a tropical beach with a corpse.

Tell Mark to see a doctor.

On a tiger perhaps. Sounds like a MacGuffin failure.

Cheers,
Tom

Not completely dissimilar is 'Brain Plague,' by Joan Slonczewski (sp?), at least in that it has intelligent microorganisms that start communicating with their hosts. I think 'The Children Star' has something to do with the superbugs, too, but it's been a while since I read it.

Your aunt may suffer from Filariasis, transmitted via a mosquito bite. It's a condition also known as Elephantiasis.

The boing-boing image sore is what we call a "target" type lesion, with a reddish center, a whitish areola, and a surrounding inflammed area. I don't exactly remember, but I think it was a characteristic sign of Leishmaniasis.