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What Causes Itchy Bites On Feet And Ankles?

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Posted on Mon, 20 Apr 2015
Question: Hi there,

My oldest is a 2d year Anes resident at a major Ivy med center--Yale was her third match choice. I graduated in the top ten percent from NYU Law School, and had egregious malpractice on my 49th b'day, 10/1/04 in Schenectady, an anterior cervical discectomy with fusion and instrumentation with cadaver bone at C3/4, 4/5. A year long odyssey, with 3 neurosurgeons and three orthopedic spine surgeons, who all agreed the first surgery was malpractice and with two screws in 6/7, lost that with autograft and the surgeon's fee was 105K plus the ENT fee (which they forgot to bill) so 10 years out, my left face is numb and I feel like I have a ligature around my throat. I have dated mabybe five doctors and made friends with two ED docs last summer in Cusco, Peru, and Galapagos. The first noticed my scars immediately and said, go have a cup of tea it will go away. The second, whose first wife died of medical malpractice at his own hospital, and he now consults on same, was not so optimistic.

2. At Machu Picchu, (read XXXXXXX Sanders, MD, XXXXXXX internist, the source and consultant for "house"), I was bitten 50 times on each ankle, with it just starting to resolve 8 months later. Dr Sanders wrote about a XXXXXXX ED resident and her BF who got cutaneous Leishmanasios in Brazil , her on arm under scrubs, and no antibiotic working, BF on chest, antibiotic working. I just visted dermatologist with two residents-0-he admits, like 6 other doctors he doesn't know, after a biopsy showing "excoriation" and wants me to go to XXXXXXX for a consult.

I have been on a medical meat grinder.

Will my facial numbness and choking ever go away.

What do I do about the 100 "bites" on feet and ankles--was in XXXXXXX basin, Galapagos, but Trip Advisor thread to 2007 says sand flies (new and old world) some with Leishmanosis, which can be carried in utero.

XXXXX

doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (10 hours later)
Brief Answer:
Please upload some picturs of the lesions, if you are comfortable.

Detailed Answer:
Hello and Welcome

I appreciate your concern

The condition that you described to be leishmaniasis would require a look before any management options are suggested. If appropriate, Kindly upload some good quality images of the lesions you described.

wishing you best of health

thanks
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Muhammad Sareer Khalil (20 days later)
Dear Doctor,

I have emailed you the reports please suggest
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (19 hours later)
Brief Answer:
Not likely to be Cutaneous Leismaniasis

Detailed Answer:
Hello again,

Thanks for uploading the images. Looking at these images there is a very low likelihood of this being Cutaneous Leishmaniasis

The likely causes can be a few. Based upon the history if associated with hiking and swimming then both Hiker's rash and swimmer's itch can present in similar manner. Staph Folliculitis can also present with a similar rash. The rash is sort of petechial and blood counts along with ESR/CRP and coagulation studies should be done to rule out Vasculitis or other bleeding disorder. As you mentioned , these bites resolved and the symptoms started 8 months later which can point to a type 4 hypersensitivity reaction esp contact dermatitis. In case of sandfly bites history , they can be bothersome for months but can clear and be self limited. However, in one of the images there was quite a bit of blood probably from the scratching due to the itching/irritation. Superimposed bacterial infections can occur if proper antiseptic surface is not maintained adequately. If the facial numbness and choking sensations are associated with diffuse spread of the rash then measles and chicken pox can be suspected especially if there is a history of incomplete vaccination coverage. As part of treatment Amoxicillin clavulanate course can be initiated empirically if you aren't penicillin allergic. Anti histamines can also be prescribed to help with any associated itching, in consult with a dermatologist.

wishing you best of health

thanks

Please consult your doctor before deciding on any further course of action.

Dr. M.S. Khalil
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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What Causes Itchy Bites On Feet And Ankles?

Brief Answer: Please upload some picturs of the lesions, if you are comfortable. Detailed Answer: Hello and Welcome I appreciate your concern The condition that you described to be leishmaniasis would require a look before any management options are suggested. If appropriate, Kindly upload some good quality images of the lesions you described. wishing you best of health thanks