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Feeling fatigue, have swelling in armpit and pain in leg joint. All medical test normal. Reason?

DOCTOR OF THE MONTH - Feb 2013
Feb 2013
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gd evening Sir . I m Male 28 years , Name XXXXXXX

from the month of september 2012 i m getting problems as mentioned below.
first i started with fatigue, after i got swelling in armpits for 3 to 4 days then it went off,i went to doctor he did various test including CBC, ESR, WIDAL , SUGAR, SGOT, SGPT, MALARIA ANTIGEN,, each test was negative. he gave me antibiotics which i continued for a month , but the problem didnt go away and then i got some itching in the anus area with very tiny and small particles which went off after few days.

fatigue continues, then doctor conducted test ASO TITRE, RA , which both were to the extreme values, ASO TITRE was 1250. i have little pain in leg joints when i fold them and fatigue. now today i have developed swelling just outside the armpit where hand and chest joins and fatigue continues plz help.
Posted Sat, 23 Mar 2013 in General Health
 
 
Answered by Dr. E Venkata Ramana 2 hours later
Hi XXXXXXX XXXXXXX

Thank you for your query on Healthcare Magic,

Extreme fatigue in your age is usually unusual.

But as you told ASO titre, and RA are positive, underlying collagen vascular diseases to be ruled out by doing further investigations.

But the swelling in armpits are due to enlarged lymphnodes which present in axilla

And as the swellings disappeared within 3 to 4 days, they may be due to a viral fever.

The itching around the anus with tiny lesions may be due to some parasitic infection like pin worm infestation.

Glandular disease is associated with lymphnode swellings and extreme fatigue.

I would like to go for the following evaluation in similar presentations :

1. For collagen vascular disorders like rheumatoid arthritis, systemic lupus
erythematosus, and dermatomyositis.

2. Thyroid function testing.

3. For glandular disease (Infectious mononucleosis).

4. To rule out any chronic infections like Tuberculosis, and HIV depending on the
presence of risk factors.

This is just my plan of action for evaluation, but the actual plan will be guided by your treating physician depending on your complaints, clinical findings on his examination, and interpreting the initial investigations done previously.

So consult your Physician, discuss your concerns and plan for the complete evaluation as per his advise.

Hope I have answered your query, if you have any clarification please feel free to consult me and I will try to advise whenever you require.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feeling fatigue, have swelling in armpit and pain in leg joint. All medical test normal. Reason? 36 hours later
GD MORNING SIR, ALSO I M HAVING ITCHING ONLY BELOW MY HIPS ON LEGS AND BUMPS, ALSO SMALL RIGID TYPE REDDISH MARKS APPEARS ON LEGS WITH ITCHING AND THEN GOES OFF AFTER 3-4 DAYS IT LOOKS LIKE AS IF A MOSQUITO BITE.
I M GIVING DETAILS OF MY TEST PLZ HAVE A LOOK AND SUGGEST ME ACCORDINGLY.
MALARIA ANTIGEN NEGATIVE
S. URIC ACID 5.8 mg/dl ( reference range 3.4 - 7.0 )
ASO SERUM 259 IU/ml ( reference range 0 - 200 )
RA 11.5 IU/ml ( reference range 0 - 12 )
TSH 4.67 (reference range 0.25 - 5 )
WIDAL ALL NILL
BLOOD SUGAR 87.5 mg/dl
HIV 1 & 2 NEGATIVE ( THERE WAS NO NEED BUT I DID IT )
URINE CA OXALATE PRESENT.

CBC

HAEMOGLOBIN 15.0
R.B.C. 5.01
PCV 44.7
MCV 89.0
MCH 29.9
MCHC 33.6
RED CELL DIST. WIDTH 13.4
TOTAL W.B.C. COUNT 8900

DIFFERENTIAL COUNT
NEUTROPHILS 52
EOSINOPHILS 09
LYMPHOCYTES 38
MONOCYTES 01
BASOPHILS 00
PLATELETS ON SMEAR ADEQUATE
PLATELET COUNT 0000
MEAN PLATELET VOL 10.2

PARASITES NOT DETECTED
R.B.C MORPHOLOGY NORMOCHROMIC & NORMOCYTIC
W.B.C MORPHOLOGY NORMAL

E.S.R ( AUTOMATED ) 07 mm/hr

plz give suggestions sir.


 
 
Answered by Dr. E Venkata Ramana 8 hours later
Hi XXXXXXX XXXXXXX

Thank you for getting back with detailed investigation reports.

In your previous query you mentioned ASO titre and RA were high. But here these values are normal.

The all values are within normal range and are not suggestive of any pathology.

The itchy rash over legs may be some allergic like hives, but to be confirmed by showing these lesions to physician whenever they appear again.

So I suggest you to consult your Physician again for further investigations if required.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feeling fatigue, have swelling in armpit and pain in leg joint. All medical test normal. Reason? 1 hour later
THANK YOU SIR, AND LAST QUESTION,

I FORGOT TO MENTION 1 THING FROM THE VERY BEGINNING MEANS LAST 7 MONTHS WHEN ALL THESE THINGS STARTED IT WAS ALSO ACCOMPANIED WITH INFLAMMATION OF EYES. I WENT TO AN OPHTHALMOLOGY AT THAT TIME SHE SAW MY EYES WITH A MICROSCOPE SHORT OF THING AND TOLD ME THAT THERE ARE SMALL GRANULES AND GAVE ME TWO DROPS AND TOLD TO USE FOR 1 MONTH .

ALSO THERE IS NOT RASH ON THE LEGS ITS JUST ITCHING WITOUT ANY MARKS FROM LAST TWO MONTH NOT FROM VERY BEGINNING NOW FROM 2-3 DAYS ITS GONE. I MENTIONED THAT THERE IS SMALL REDDISH IN SHAPE AND SIZE OF 1/4 OF A PEA SIZE WHICH COMES AND ITCHES AND THEN GOES OF WITH IN 2 -3 DAYS, AS IF WHEN A MOSQUITO BITES .THIS STARTED FROM BEGINNING ONLY .

IF ALL REPORTS ARE NORMAL THEN WHY I AM GETTING THESE HEALTH PROBLEMS
LIKE FATIGUE , INFLAMMATION OF EYES ( OPHTHALMOLOGY ALSO DIDN'T TOLD ANY THING ) , AND MINUTE SWELLING WITH VERY LITTLE PAIN IN ARMPIT , JUST LITTLE DOWNWARD FROM ARMPIT ( LEFT ONE ) . BUT THESE ARMPIT PROBLEM OCCURRED THRICE ONLY IN LAST 7 MONTHS AND GOES OFF WITH IN 3-4 DAYS.

PLZ SUGGEST.

RGRDS
 
 
Answered by Dr. E Venkata Ramana 26 minutes later
Hi XXXXXXX XXXXXXX

Thank you for getting back.

The itchy legs are looking like of allergic origin.

If you have any history of allergy to food, drugs, and any plants, try to avoid.

Some times allergy to intestinal parasites may also presnt with itchy skin lesions and you told some itching around anus with some particle like lesions-which may correlate with worm infestation.

I can understand your concern as investigations some times won't be useful in some conditions like skin allergies and nonspecific inflammations.

In these situations regular follow up with a good and experienced physician will be helpful in detecting the cause and its appropriate treatment.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
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