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What Causes Swelling In Hands And Legs After A Viral Infection?

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Posted on Thu, 8 May 2014
Question: Health update April 10th. Started really not feeling well 8 days ago. Monday 04/07,my mom was pushing it a bit with lifting and all and since my dad has been put on oxygen, her workload has increased.  the next day, she slept all day and night, ate nothing, drank nothing, same the next day. When I saw her Thursday 4/10, she was completely pale and had a fever of 102.7. Didn't even realize she had a fever, she told me she didn't but I took it anyway. Her BP was very high a few days prior to all these symptoms beginning, bottom number being 108 and she is ON blood pressure medication. It has been spiking up, then spiking low. She finally went to the doctor Friday, 4/11.  Predicted a virus based on her symptoms of high fever 102.9 at the doctors that day, nausea, lack of appetite & severe fatigue and her liver count was 51.  2 days after this appointment, her knees swelled up very badly, to the point she could barely get herself up and down and would limp while walking, again, all the same symptoms as before plus swelling in the knees, no where else, but not a severe fever. This was on Sunday 4/13. Monday 4/14, her hands and fingers began swelling but she said swelling decreased a bit in her knees but not completely. Dr asked if she has been exposed to fifth disease, in which mom said no she has not. Assuming its her arthritis / bursitis acting up.  All I do know, is if anything, she is worse than last week not better. I would hope if was just a virus she would be improving by now. She looks frail, pale, no appetite which is NOT like her, she is far from herself, and extremely fatigue is almost and understatement. I have been considering taking her to ER.  Last night she mentioned her urine has had a very bad foul smell and been dark for a few months, which caused me to once again be concerned there is something else going on here especially seeing protein was found in her urine. I noticed some of the bloodwork that is high and / or low represent or could represent more than just a virus. Is that normal for just a virus??  She mentioned last night she was put on evista, for her bones a few months back. Could this possibly be due to side effects?  I just wanted to discuss the symptoms I have seen and have heard her tell me and my dad (she tells me she's fine normally so not to worry but dad calls to tell me what is going on). Any signs to look for of when should take her to ER at all? My dad recently had rupture collapsed lungs so it's extremely important he does not get sick after only being out of hospital a month and a half Heart problems run on mom's side of the family. With her sudden symptoms, history of blood pressure, current stress, etc, I just want to take extra precaution.  Bloodwork: BUN: 13  BUN/CREAT Ratio: 16.7  Creatinine: 0.78  GFRA: >60  GFRC: >60  AGAP: 12  Chloride: 94  CO2: 27  Potassium: 3.6  Sodium Level: 133  ALT (SGPT): 13  AST (SGOT): 51  Abs Basos - Auto: 0.0  Abs Eos Auto 0.0  Abs Lymph - Auto: 0.8  Abs Mono - Auto:L 0.6  Abs PMN - Auto: 4.7  Basophil Auto: 0.4  Eos Auto: 0.4  Lymph Auto: 12.9  Mono Auto: 10.1  Neutro Auto: 76.3  Hct: 42.1  Hgb: 13.6  MCH: 29.8  MCHC: 32.4  MCV: 92  MPV: 10.3  Platelet: 117  RBC: 4.58  RDW: 12.5  WBC: 6.1  Urinalysis: Specific Gravity: 1010  pH: 6  Protein: 30, everything else negative. When I say worse than last week I guess I mean with additional symptoms. She doesn't have a fever as severe as 102. 100 or less April 18 update She has gone back to the doctor today. She still has a fever it was 100.00 while at the doctors. Dhe had fever of 101 latrr this evening. They took a chest xray since she's not completely better and her lungs have fluid in it. They prescribed zithromax. Her blood work in some areas was better but worse in others. The swelling has gone down a little bit. Blood work as follows shows last weeks result / to the right of slash is this week's result:  Ast/agot: 51/29 Lymph auto: 12.9/13.6 Alt/sgpt: 13/34 Nuetro: 76.3/75.4 Platelets: 117/292 Wbc: 6.1/9.1 Rbc: 4.58/3.98 Chloride: 94/98 BUN: 16.7/20.9 Does pneumonia really sound like the problem? They said a virus, pneumonia and her arthritis is inflamed causing knees and hands to swell.  
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Answered by Dr. Dr. Prasad J (2 hours later)
Brief Answer: Viral infection... Detailed Answer: Hi, I went through your details with diligence. You have provided plenty of information about your mother; I appreciate it. I would also like to know if she traveled out of the country recently. Poly arthritis is a feature of most viral infection. But some strains of virus cause severe arthitis. Mumps (fifth disease) is one such virus. Besides that other viruses like dengue, parvo virus, alpha virus, are known to cause severe arthritis. It is noted that most of these virus are arthropod (mosquito) borne. Therefore if she had traveled out of the country to part of Africa and Indian subcontinent, it is likely related. I am not sure if such infections are known entities in your part of the world. Discuss about it with the treating doctor / ask for infectious disease specialist reference. These viruses can be diagnosed based on serological tests. Pleural effusion is also explained by these viral infections. I went through the blood reports and I don't see any serious alarms yet. But if she persist to have fever, I would like to monitor her liver functions, hematocrit and platelet counts. Hope this helps. Let me know if you need clarifications. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Prasad J (4 hours later)
Thank you I will surely follow up. So would you not predict pneumonia based on bloodwork and xray? My father recently had a ruptured collapsed lung just want to make sure we keep him healthy and get mom better. No she has not been out of the country at all.
doctor
Answered by Dr. Dr. Prasad J (41 hours later)
Brief Answer: I wouldn't list pneumonia.... Detailed Answer: Hi, Apologies for the late reply. Well pneumonia can be due to viral causes. Those dangerous stories about pneumonia are mostly due to bacterial infections. Based on her symptom profile and blood work up even if she had pneumonia, I feel its from the same virus. Systemic viral infections can involve multiple organs including lungs. So discuss about serological tests with her treating physicians. Frankly, in the absence of cough and breathing issues serious pneumonia was never in my list of possibilities. Further I felt her doctors referred to fluid in the pleural sac which is medically referred to as pleural effusion when they said she has fluid in lung cavity. If you have X-ray films or X-ray reports, please upload it on this page using the feature provided on the right side. I will be available for clarifications. Feel free to write back... Good luck!!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Prasad J (10 hours later)
Thank you. Trying to get her into hospital today. She woke up with eye completely bloodshot very very red. Fever has gone down to 100 and feeling a little better however she's been on zithromax for 4 days now....any ideas on eye issue relation?
doctor
Answered by Dr. Dr. Prasad J (16 hours later)
Brief Answer: Needs clinical examination... Detailed Answer: Hi, Congested conjuctiva (red eye) are linked to infection, allergy and other local eye conditions. In the back ground of infection, I would easily relate it to her infection. Please discuss about possible viral infections and subsequent investigations. Overall, I would be happy if she is improving gradually. Encourage her to drink lots of fluids. Regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Prasad J

General & Family Physician

Practicing since :2005

Answered : 3708 Questions

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What Causes Swelling In Hands And Legs After A Viral Infection?

Brief Answer: Viral infection... Detailed Answer: Hi, I went through your details with diligence. You have provided plenty of information about your mother; I appreciate it. I would also like to know if she traveled out of the country recently. Poly arthritis is a feature of most viral infection. But some strains of virus cause severe arthitis. Mumps (fifth disease) is one such virus. Besides that other viruses like dengue, parvo virus, alpha virus, are known to cause severe arthritis. It is noted that most of these virus are arthropod (mosquito) borne. Therefore if she had traveled out of the country to part of Africa and Indian subcontinent, it is likely related. I am not sure if such infections are known entities in your part of the world. Discuss about it with the treating doctor / ask for infectious disease specialist reference. These viruses can be diagnosed based on serological tests. Pleural effusion is also explained by these viral infections. I went through the blood reports and I don't see any serious alarms yet. But if she persist to have fever, I would like to monitor her liver functions, hematocrit and platelet counts. Hope this helps. Let me know if you need clarifications. Regards