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Consistent Foot Swelling. Earlier Had Nausea, Diarrhea And Low Grade Fever. Is Treatment Required?

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Posted on Tue, 28 May 2013
Question: Writing for my husband, who does not want to go to the ER or a clinic for financial reasons.

Symptoms as follows:

Feb. 28 nausea, diarrhea and low grade fever 3 days after having raw oysters in Florida.
March 8 onset of stiff neck, very bad, including cramping, enlarged lymph nodes, both sides of neck. Redness at end of penis (he thought was maybe due to soap), low grade fever, chills and night sweats (having to towel off in middle of night).
3 weeks later, complaints about "dropping things"
also said he "was getting better"
April 12, complaints of swollen sore feet and legs (thought due to work), said "night sweats were over"
April 14 Temp. of 100.8 F, had wet sheets
Night sweats continue, getting up usually once to towel off. Additional symptom of redness and sores around penis (had negative Herpes test in 2001, prior to our marriage)
April 25, sore penis much improved, lymph nodes pretty much back to normal, stiff neck almost gone, temperature normal.
April 25 - lab results: CRP is 6.0, Sed Rate is 50. Other labs normal (ASO, RF, CBC, COMP). (Did not do Uric Acid)
May 4 - right foot swelling worse, said no night sweats for 3 or 4 nights

My concern is the right foot swelling, and should he be persuaded to see a physician?
doctor
Answered by Dr. Mayank Bhargava (2 hours later)
Hi XXXXXXX,
Welcome to XXXXXXX forum.

Let me know your other associated symptoms along with mentioned.
Do you have some sort of infection at vaginal area?
Does enlarged lymph nodes tender in nature?

With the available described details, there appears to high possibility of Acute viral gastroenteritis with STDs at penis.
Associated neck pain appears to be due to myalgia which is an integral symptom of viral infection.
Skin lesion at penis along with enlarged lymph nodes suggests possibility of STDs.
Enlarged lymph nodes may cause pressure effects on femoral vein and may cause swelling in lower limbs.

You should consult with XXXXXXX medicine specialist/ dermatologist and should go for thorough check up.
You should go for complete blood count, peripheral blood film, excision biopsy of enlarged lymph nodes.
Your husband should also go for color doppler studies of both lower limbs.

Treatment depends on exact diagnosis.
Treatment is mandatory to protect deep vein thrombosis in lower limb veins.

He should take complete antibiotic therapy, anti-inflammatory, magnesium sulphate dressings.
He should keep his lower limb elevated to reduce edema.
He should also apply hot fomentation.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mayank Bhargava (3 hours later)
Thank you for your response.

I have no vaginal infection. My husband, prior to our marriage, was tested negative for STD's including herpes in 2001, and we have both been monogomous. The sores / inflamation have cleared up.

The lymph nodes have gone down and were not tender.

The CBC with periferal smear was normal (no increase in lymphs or atypical lymphs).

Could Acute gastroenteritis linger this long? The stiff neck, low grade fever, chills, and night sweats lasted almost two months.

I will try to convince him to get in for a thorough exam.

Thank you for your help.
XXXXXXX

doctor
Answered by Dr. Mayank Bhargava (8 minutes later)
Hi Deanne Swenson,
There appears to be least correlation between gastroenteritis and groin lesion.
Although condition has been improved drastically but there could be possibility of localized fibrosis and compression at inguinal region.
Your husband should go for color doppler studies of lower limb.
Best regards,
Dr. Mayank Bhargava
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Mayank Bhargava

Internal Medicine Specialist

Practicing since :2003

Answered : 1658 Questions

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Consistent Foot Swelling. Earlier Had Nausea, Diarrhea And Low Grade Fever. Is Treatment Required?

Hi XXXXXXX,
Welcome to XXXXXXX forum.

Let me know your other associated symptoms along with mentioned.
Do you have some sort of infection at vaginal area?
Does enlarged lymph nodes tender in nature?

With the available described details, there appears to high possibility of Acute viral gastroenteritis with STDs at penis.
Associated neck pain appears to be due to myalgia which is an integral symptom of viral infection.
Skin lesion at penis along with enlarged lymph nodes suggests possibility of STDs.
Enlarged lymph nodes may cause pressure effects on femoral vein and may cause swelling in lower limbs.

You should consult with XXXXXXX medicine specialist/ dermatologist and should go for thorough check up.
You should go for complete blood count, peripheral blood film, excision biopsy of enlarged lymph nodes.
Your husband should also go for color doppler studies of both lower limbs.

Treatment depends on exact diagnosis.
Treatment is mandatory to protect deep vein thrombosis in lower limb veins.

He should take complete antibiotic therapy, anti-inflammatory, magnesium sulphate dressings.
He should keep his lower limb elevated to reduce edema.
He should also apply hot fomentation.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava