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What Do Sore Throats, Fever And Red Spots On The Legs Indicate?

Posted on Fri, 13 Oct 2017

Question: Hi, My sister lives in Brazil and recently developed strange symptoms. It started with sore throat then had red spots all over her legs. She did all kinds of lab tests, ( to include Dengue, Zica and the like) and all came out ok, except Protein A reactive. All symptoms went away. Then they came back after 4 or 5 months: sore throat, fever, red spots on the legs and joint pain.She went to md again and is waiting on tests for Rheumatism, Cancer and others. What do you think it could be? And any suggested treatment? Thank you so much, Mitzi

Answered by Dr. Shafi Ullah Khan (1 hour later)

Brief Answer:
Needs work up and management

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. The list of differential of sore throat with a rash is big and needs to be worked up for all the possibilities. Some possibilities are infectious mononucleosis, scarlet fever, fifth disease, measles, hand foot and mouth disease, vasculitis, west nile viral infection, adult onset stills disease and rheumatic disease etc. It needs complete rheumatological and clinical correlation and thorough work up to find out the possible cause. It could be viral or an autoimmune or a systemic illness. Only complete clinical correlation will narrow the differentials. Consult a good physician nearby and let them take it from there.

I hope it helps. Take good care of yourself and dont forget to close the discussion please.

Regards
Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shafi Ullah Khan (37 hours later)

Thank you for your advice, Dr. XXXXXXX

My sister just have another question. She wanted to know what other lab exams you recommend. (Thank you for mentioning West Nile virus, I guess it's a different exam than Dengue, Zika and chikungunya which were negative for her)

Here are the other exams that her doctor requested(and she is still waiting on results): complete blood count,glycemia, total cholesterol, HDL, LDL, triglycerides, uric acid, creatinine, urea, sodium, potassium, calcium, zinc, iron, ferritin, vit.b12, vit.D, glycated hemoglobin, TSH, T4, gamma GT, TGO, TGP, amylase, rheumatoid factor, FAN, total IgE, CEA, cortisol, TAP and urine.

So the question is, What other blood tests do you recommend?

Thank you again for your interest in this case.

Answered by Dr. Shafi Ullah Khan (11 hours later)

Brief Answer:
Let the results come

Detailed Answer:
Thank you for getting back to me

The lab work which is requested is thorough enough and will pick up any abnormality or pathology if there. Lets wait for the reports and see what happens. Supportive care for sore throat is advised.

I hope it helps.
Regards
Khan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar