Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Severe Itch All Over Body With Numbness And Tingling In Feet. Is This Parasitic Infection?
Question: hi, I have severe itch randomly all over body (including scalp above ears) without rash . This is associated with burning feet. The itch is sometimes is sharp stab like jab and sometimes feels like electrical sparks with numbness and tingling in feet. All this increases by night. CRP is 3.69, ESR is 42, B12 386, folate 5.0, CH50 >60, C4C 17, C3C 181, Neuronal nuclear anti HU AB W/Reflex tire and WB showed fluorescence but WB results were negative, Glucose tolerance test at 2 h was 130, HDL 37. EMG of hands feet showed carpel tunnel in hands. X-ray showed mild cervical spine degenerative disease with reversal of lordosis in upper cervical spine and L5-S1 degenerative with rotary extra scoliosis and neuroforaminal stenosis, no instability. My doctor has conducted brain MRI and rheumatologist ordered a bunch of tests some including ACLA, RNP, Hep tests, Quanterferon TB, chromatin, comprehensive metabolic panel, JO-1, Vit D 25-OH, SS-A/B, etc. Have been hypothyroid for >10 yrs and it is controlled. What the docs looking for. Could any of my symptoms be due to nerve root compression? The itch is sometimes associated with numbness and pain in the toes or fingers and sometimes jabs of pain. All the symptoms increase a time of the week and decrese - the pattern shifts - might increase during weekend and decrease by Friday - pattern increase progressively 3-4 days and decrese the next few days within a week.All this has been for over 3 months now. Internet thread also suggested parasite infection - seems rather far fetched but can it be true? Waiting for brain and other test results. Doctor want chest X-ray to look for nodules. Waiting results
Brief Answer:
Coordinated rheumatologic and neurosurgical evaluation required
Detailed Answer:
Hi and thanks for the query,
I agree with you on the fact that it is almost impossible that the symptoms you are experiencing be due to a parasitic infection. Numbness, pain and sensation of electric discharge are very compatible with a nerve root compression. Considering the proven diagnosis of degenerative vertebral stenosis, this further strengthens this possibility.
It s interesting since the rheumatologist is already searching for a possible causative mechanism for the condition for this shall very much influence management. Normal CrP levels exclude possibility of a bacterial infection. A slightly raised ESR at over 40 indicates a chronic inflammatory process, which with the complete rheumatologic work up shall be useful in identifying a possible causative mechanism.
I think despite normality of Vitamin B levels tested, in my experiencing, moderate supplementation in the Vitamin complex class of vitamins usually alleviate symptoms. I would also suggest that blood Calcium and Magnesium levels be tested. Deficiencies in these minerals usually produce some neurologic manifestations.
A coordinated evaluation by the rheumatologist and your neurosurgeon should lead to remarkable progress and consequent better outcome and quality of life. I would be glad to answer any further specific concerns that you might have. Do not hesitate asking follow up questions. Kind regards as I wish you good health.
Bain LE, MD
Coordinated rheumatologic and neurosurgical evaluation required
Detailed Answer:
Hi and thanks for the query,
I agree with you on the fact that it is almost impossible that the symptoms you are experiencing be due to a parasitic infection. Numbness, pain and sensation of electric discharge are very compatible with a nerve root compression. Considering the proven diagnosis of degenerative vertebral stenosis, this further strengthens this possibility.
It s interesting since the rheumatologist is already searching for a possible causative mechanism for the condition for this shall very much influence management. Normal CrP levels exclude possibility of a bacterial infection. A slightly raised ESR at over 40 indicates a chronic inflammatory process, which with the complete rheumatologic work up shall be useful in identifying a possible causative mechanism.
I think despite normality of Vitamin B levels tested, in my experiencing, moderate supplementation in the Vitamin complex class of vitamins usually alleviate symptoms. I would also suggest that blood Calcium and Magnesium levels be tested. Deficiencies in these minerals usually produce some neurologic manifestations.
A coordinated evaluation by the rheumatologist and your neurosurgeon should lead to remarkable progress and consequent better outcome and quality of life. I would be glad to answer any further specific concerns that you might have. Do not hesitate asking follow up questions. Kind regards as I wish you good health.
Bain LE, MD
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks very much. Can you clarify if you said C-reactive protein was normal? Lab report says high. Though not proven, I know it is correlated with cardiac problems. Have a history of parents with cardiac and cancer (father with cardiac and mother passed away with NHL) issues. Could my symptoms be due to surrounding environment ie mold, paint etc in my house? Likewise could they suspect choestasis (normal LFTs and Tbil 3 months ago), candida infection, MS (hence they ordered brain MRI), Lupus (hence rheumatologist order extensive panel)? I had x-ray of neck and lower back and mentione the results above. Would liver or kidney issues. I was surprised by Quanterferon TB ordered. Looked the test up on internet - says test for Latent TB - don't have any symptoms. Is this a regular default test? Does high ESR amount to infection? In the meawhile my symptoms have existed over 3 months and are horrible. Sometimes they make me jump, as itch and burning sensation feels like firecracker under the skin. Would appreciate your response.
Brief Answer:
No major worries, see neurosurg and rheumatologist
Detailed Answer:
hi and thanks for the follow up question.
A C reactive protein level of less than 6mg/dl is considered normal. I do not believe the symptoms you are presenting with really have much to do with your environment. An X XXXXXXX gives a good idea of the nerve compression and status of the vertebral column. However, an MRI gives a better picture, with status of the surrounding structures and a more detailed impression of state of function of these structures. It is better in making a clinical decision with more precision, compared to a simple X XXXXXXX Kidney and liver problems in this context would rarely actually present with the symptoms you present with.
I think its logical to rule out Tb under these circumstances. A common site of Tb infection is the spine, a disease called pott's disease. An ESR, X XXXXXXX images and clinical symptoms could lead to suspicion of such an infection. In some circumstances, some patients a usually put on a test treatment (therapeutic trial) on anti TB drugs, and some at times do obtain spectacular improvement.
Considering the fact the symptoms have existed for quite sometime (3 months), it further strengthens the suspicion of TB.
I still think the opinion of a neurosurgeon and your rheumatologist shall be most helpful, also taking consideration the suggestions made above. With MRI, complete blood count and X rays, it would be easy to readily rule out a lymphoma. Thanks and hope this helps as I wish you the best of health. Kind regards. Feel free asking more questions in case of need.
Bain LE, MD
No major worries, see neurosurg and rheumatologist
Detailed Answer:
hi and thanks for the follow up question.
A C reactive protein level of less than 6mg/dl is considered normal. I do not believe the symptoms you are presenting with really have much to do with your environment. An X XXXXXXX gives a good idea of the nerve compression and status of the vertebral column. However, an MRI gives a better picture, with status of the surrounding structures and a more detailed impression of state of function of these structures. It is better in making a clinical decision with more precision, compared to a simple X XXXXXXX Kidney and liver problems in this context would rarely actually present with the symptoms you present with.
I think its logical to rule out Tb under these circumstances. A common site of Tb infection is the spine, a disease called pott's disease. An ESR, X XXXXXXX images and clinical symptoms could lead to suspicion of such an infection. In some circumstances, some patients a usually put on a test treatment (therapeutic trial) on anti TB drugs, and some at times do obtain spectacular improvement.
Considering the fact the symptoms have existed for quite sometime (3 months), it further strengthens the suspicion of TB.
I still think the opinion of a neurosurgeon and your rheumatologist shall be most helpful, also taking consideration the suggestions made above. With MRI, complete blood count and X rays, it would be easy to readily rule out a lymphoma. Thanks and hope this helps as I wish you the best of health. Kind regards. Feel free asking more questions in case of need.
Bain LE, MD
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
