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What Causes High Fever And Rashes On Legs?

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Posted on Thu, 20 Apr 2017
Question: Hello there! I was in Ecuador from November through February. On February 19 a started to have a high fever which last a couple of days. On February 22 I noticed the beginning of a rash on my arms and legs... all these being symptoms of dengue. I thought I was over it, but then on February 24 to 26, my left toe became numb and in the next days most of my left foot became numb (there was also some swelling of my ankle), part of my right foot (but much less) and then also fingers 3,4,and 5 on each hand! Then the pain began on Feb 25/26... I don't know how to describe it, but I could hardly sleep. At times the bed was shaking with my trembling. I went to Emergency at midnight on February 27... I was attended, but they just gave me a strong sleeping pill to knock me out. In the morning, the pain returned with vengeance. A friend sent a doctor that evening... she said she thought I had chikungunya and ordered a blood test. The test results came back negative for dengue and chikungunya. I had planned to return to Calgary on February 27, but the pain which was worse from 9:30 PM through to the morning, made an overnight international flight impossible. I rebooked my ticket for March 8 and hoped I would be better. A nurse/friend gave me an intramuscular injection to help reduce the pain 3 days before the flight, including just an hour before I went to the airport. The night before my flight was the first night I slept more than 5 hours. I should mention that I discovered that strong coffee in the morning had an almost instant effect on the pain... after two sips I literally felt the pain leaving my body! Then I went to the bed to sleep a couple of hours. I even tried coffee in the night to 'treat' the pain, but I soon habituated, and the effect diminished rapidly... I had to wait for the morning jolt.
When I arrived in CAlgary on March 9, I immediately called my GP and he ordered a blood test for zika, dengue and chikungunya. The results came in after a week: negative for all three. My doctor says I have an UNKNOWN tropical illness and I'm on my own.
In that last week in Ecuador I lost more than 10 pounds... I was down to 90 lbs. when I arrived home. Now I am up to 93 lbs. eating as much steak, potatoes, sour cream and salad as I can manage.
My biggest concern is whether I will get back sensation and fine motor control in my feet and hands. So far, after a month, I can't see I see much improvement. My friends in Ecuador say that people who get chikungunya often have this numbness, but that they eventually return to normal after a month or a sometimes a year. Having this condition is very debilitating.. but the worst is not knowing what is really going on and what my prospects are.
I thought a neurologist might have seen this condition or similar before and could shed some light.
doctor
Answered by Dr. Sudhir Kumar (5 hours later)
Brief Answer:
Symptoms are suggestive of post-infectious polyradiculoneuropathy.

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist working in XXXXXXX (about 20 years of experience), and would try my best to help you.

I have noted your symptoms and they are suggestive of post-infectious polyradiculoneuropathy. Please do not get scared with the name of the disease (Neurology is full of these scary names). It just refers to damage of sensory and motor nerves following an infection, which is most often a viral infection.

So, to start with you had a viral infection. Our body tries to fight any infection by producing antibodies against the infective agent. In most cases, everything goes well and the infection gets cured. In some cases, the antibodies, which are supposed to attack the virus, by mistake, attacks our own nerves, which leads to this disease.

The disease has varying severity. In most severe cases, the person can be totally paralysed for 6 months or more. In less severe cases, there is mild weakness, numbness and pain, as in your case.

The diagnosis can be confirmed by doing nerve conduction studies.

For faster recovery, in acute phase (within one month of symptom onset), we use medications like steroid or immunoglobulin injections. After one month, they do not have much benefit.

As of now, you need medicines (pregabalin or duloxetine) to relieve the nerve-damage related pain. Regular exercises and good diet should be continued.

Recovery period is variable and ranges from one month to several months (most patients recover, though).

I sincerely hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sudhir Kumar (11 hours later)
Hello Dr. XXXXXXX

I don't have a follow-up question because I think you addressed my concerns sufficiently. I just want to say 'thank you' and add how much I appreciate your taking the time to answer my query. I am in agreement that it seems the nerves in my extremities were damaged by the inflammation mounted by my immune system in response to the viral infection. The pain I experienced in the first week was not in my hands and feet, but all over my body. Fortunately, I have no more pain anywhere! So all that is left to do is to eat, exercise and apply heat. However, to know that it is possible to recover from nerve damage and that most people similarly affected do recover is a tremendous relief for me and will help me stay positive.

Many thanks,

Heidi
PhD cell biology
doctor
Answered by Dr. Sudhir Kumar (8 hours later)
Brief Answer:
Thank you.

Detailed Answer:
Wishing you a speedy recovery,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

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What Causes High Fever And Rashes On Legs?

Brief Answer: Symptoms are suggestive of post-infectious polyradiculoneuropathy. Detailed Answer: Hi, Thank you for posting your query. I am Dr Sudhir Kumar, Neurologist working in XXXXXXX (about 20 years of experience), and would try my best to help you. I have noted your symptoms and they are suggestive of post-infectious polyradiculoneuropathy. Please do not get scared with the name of the disease (Neurology is full of these scary names). It just refers to damage of sensory and motor nerves following an infection, which is most often a viral infection. So, to start with you had a viral infection. Our body tries to fight any infection by producing antibodies against the infective agent. In most cases, everything goes well and the infection gets cured. In some cases, the antibodies, which are supposed to attack the virus, by mistake, attacks our own nerves, which leads to this disease. The disease has varying severity. In most severe cases, the person can be totally paralysed for 6 months or more. In less severe cases, there is mild weakness, numbness and pain, as in your case. The diagnosis can be confirmed by doing nerve conduction studies. For faster recovery, in acute phase (within one month of symptom onset), we use medications like steroid or immunoglobulin injections. After one month, they do not have much benefit. As of now, you need medicines (pregabalin or duloxetine) to relieve the nerve-damage related pain. Regular exercises and good diet should be continued. Recovery period is variable and ranges from one month to several months (most patients recover, though). I sincerely hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/