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Dr. Andrew Rynne

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What could cause swollen glands and red patches on arms after fever?

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Dr. Raju A.T

General & Family Physician

Practicing since :2008

Answered : 3695 Questions

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Posted on Wed, 27 Aug 2014 in Skin Hair and Nails
Question: I had a fever as high as 103 from July 14 - 7/18/14 when it finally broke on the night of 7/18/14. Blood work indicated everything normal except high liver enzymes. After the fever abated, I noticed swollen glands below the jaw and began getting blotchy red patches on my arms, chest, stomach and legs. They started out ranging in size from 1 - 2 inches, but have since increased in size. The glands are no longer swollen, however, I have been very fatigued the last 4 days and urinate frequently. A subsequent blood test indicates liver enzymes back to normal. My MD doesn't have a clue and advised I see a dermatologist. However, I know the skin blotches are only symptomatic and do not want to spend the money on something that won't pinpoint the cause. What do you suggest?
doctor
Answered by Dr. Raju A.T 6 hours later
Brief Answer:
Could be a viral infection

Detailed Answer:
Hi,

Thanks for your query.

The symptoms you had could be due due to viral infection.

This can be ascertained by the platelet count at that time. I would like to know the platelet count.

Please do attach the report of the blood tests you underwent then. No matter they are in normal range.

Waiting for the reports.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 19 hours later
Attached are the results of my blood/urine lab tests

In addition, I had a low grade fever last night of 100.4F. I took 3 Advil. Today my temp is 99. The red blotches have increased across my stomach and chest. Again, these 1st appeared 7/19/14 the day after my fever broke. They have incresed in size.

Base of the neck is sore/aching
doctor
Answered by Dr. Raju A.T 3 hours later
Brief Answer:
Platelet count

Detailed Answer:
Hi,

Thanks for the report.

The report does not contain platelet count test.

Platelet count will be seen reduced in viral infections. The same can also cause rashes as you describe.

I suggest you to get the platelet count done. This would help us to arrive at diagnosis. Meanwhile do take Tab advil but not more than twice daily.

If the rashes itch then do take a a dose of Benadryl.

Waiting for your response,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 8 minutes later
Did you page down far enough on the attached lab?

CBC W/DIFF (LAB'S ORDER) - Final result (07/18/2014 3:28 PM CDT)
Component Value Range
WBC Count 4.0 4.0-11.0 K/uL
RBC Count 4.90 4.30-5.80 M/uL
Hemoglobin 15.2 13.5-17.5 g/dL
Hematocrit 44.8 40.0-52.0 %
MCV 91.4 80.0-100.0 fL
MCH 31.0 26.0-34.0 pg
MCHC 33.9 31.0-36.0 g/dL
RDW 12.7 11.5-14.5 %
Platelet Count 134 130-400 K/uL
MPV 9.4 9.3-12.5 fL
Granulocytes 76.1 42.0-75.0 %
Lymphocytes 13.8 13.0-44.0 %
Monocytes 9.8 4.0-12.5 %
Eosinophils 0.0 0.0-6.0 %
Basophils 0.3 0.0-2.0 %
Absolute Granulocytes 3.1 2.0-8.6 K/uL
Absolute Lymphocytes 0.6 0.9-4.2 K/uL
Absolute Monocytes 0.4 0.3-1.2 K/uL
Absolute Eosinophils 0.0 0.0-0.5 K/uL
Absolute Basophils 0.0 0.0-0.2 K/uL
Diff Type Auto
CULTURE,

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Follow up: Dr. Raju A.T 0 minute later
There's more if you page down on the attachment.
doctor
Answered by Dr. Raju A.T 1 hour later
Brief Answer:
Viral infection

Detailed Answer:
Hi,

I am sorry there was a technical error in downloading the report.

Now I can scroll down. I have seen all your reports.

As I suspected, the platelet count in the recent day's report is towards the lower range. It does indicate presence of viral infection of milder severity.

Well, there are no antivirals which could be used in the treatment. You may have to take symptomatic treatment for the problems you have. Continue Advil twice daily for three days more.

Repeat the platelet count if the fever does not subside within a week from now. Also, then there would be need for a cover with antibiotic course to prevent super-added bacterial infections.

Hope, I answered your query.

Wish you good health.

regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 22 hours later
Thank you. Just one more question - My fever began on 7/14/14, broke on 7/19, did not come for several week, but is back again from 8/4-present (right now at 99.8). My skin discoloration is spreading. Do I just let it runs its course besides treating the rash?
doctor
Answered by Dr. Raju A.T 13 hours later
Brief Answer:
Observe the fever

Detailed Answer:
Hi again,

Do observe the body temperature regularly, if there are any spikes crossing 100f then a bacterial infection can be suspected. Then you may have to be placed on antibiotics. If fever is low, need not worry you can wait for a week more.

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