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Lower flank area sore and red. Feeling flu like symptoms. On doxycycline. Not getting cured. Worrisome

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Oncologist
Practicing since : 2002
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MY FATHER IS 53. A FEW WEEKS AGO HE THINKS HE WAS BITTEN BY SOMETHING IN THE RIGHT LOWER FLANK AND THE AREA BECAME VERY RED AND HOT. A FEW DAYS AFTER THAT HE GOT FEVER AND JOINT PAIN AND FELT LIKE HE HAD THE FLU.HE ALSO HAD SEVERE LEFT SHOULDER PAIN RADIATING TO HIS NECK AND LEFT LOWER BACK PAIN. ABOUT A WEEK AFTER THE INITIAL BITE, THE FEVER WENT AWAY BUT HE DEVELOPED A RED RASH OVER HIS UPPER TORSO. HE DENIED BURNING OR ITCHING AND IT WAS NOT HIVES.HE WENT TO THE ER AND THEY SENT HIM HOME, NEVER DID ANY TESTS. TOLD HIM IT WOULD GO AWAY. FEW DAYS LATER HE WENT TO THE FAMILY DR WHO TESTED HIM FOR SPIDER BITES, AND OTHER BITES BUT DID NOT FEEL IT WAS LYMES DISEASE, BUT HE GAVE HIM DOXYCYCLINE TO TAKE FOR A TOTAL OF 4 WEEKS. THE RASH LEFT, BUT HE STILL HAS PAIN IN THE LEFT SHOULDER. THE PAST FEW DAYS HE HAS DEVELOPED SWELLING BEHIND THE LEFT CLAVICLE AND INTO THE UPPER ARM, HE DENIES INJURY BUT HAS PRONOUNCED VEINS IN THE LEFT UPPER ARM AND CHEST REGION AND ALSO HAS SOME ECCHYMOSIS IN THE ANTERIOR UPPER ARM ( THAT IS IN A STREAK LIKE PATTERN). HE DENIES NUMBNESS AND HAS A GOOD RADIAL PULSE. HE IS ABLE TO LIFT THE ARM UP BUT IT IS VERY PAINFUL.HE REFUSES TO GO GET CHECKED. HE WAS NEVER TO A DOCTOR BEFORE THIS, SO WE WERE LUCKY TO MAKE HIM GO THE PAST 2 TIMES. PLEASE HELP.
Posted Sat, 18 Aug 2012 in Infections
 
 
Answered by Dr. Robert Galamaga 2 hours later
Hello and thank you for cementing your question.

Your question is a very good one and I will work on providing you with some suggestions regarding what is going on.

First of all it is obvious that he needs to visit a physician as soon as possible for a good physical examination. Additional blood tests or possibly imaging studies may need to be performed given the severity of his pain and the swelling that is evident.

This could all be just related to inflammation after the insect bite and infection. However, the severity of his symptoms is concerning.

Other concerns could be that he might have a smoldering infection going on that was not adequately treated by the doxycycline. In addition there maybe something completely unrelated that has now become unmasked.

Again I think it is imperative that he visits a physician as soon as possible for a physical examination, consultation as well as diagnostic evaluation.

There is simply no reason to wait to have this evaluated.

Thank you again for submitting your question. I hope you found my response to be helpful. If you have additional concerns I would be happy to discuss those with you as well.

Sincerely,

Dr. Robert

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