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What Causes Severe Sore Throat Along With Rashes On Both Thighs?
Question: I am a 59 year old female. 2 1/2 years ago I suddenly came down with a wicked sore throat for two ( nights only ). I then noticed a rash on both of my thighs that seemed to move and change shapes.The rash did not itch, I only knew I had it because I saw it . I immediately went to the doctor thinking strep. Strep was negative and she was stumped about the rash. A few nights later my right knee felt like it had been slammed . No swelling, no injury done to it. I had a hard time putting weight on it. Thre next day it was sore, the next day gone with a little bit of tenderness to the touch. That night it was my left knee, same scenario. A few days later they top of both ankles, then my elbows .......
We tested for Lyme Disease that came out negative. My sed rate was 77, and that was one month into it. We checked my sed rate periodically and it gradually returned to normal.
That was Summer 2012. The same thing has started again this week, February 2015. Same intermittent sore throat, rash on thighs, migrating intermittent knee pass. I went to the Doctor. Same confused reaction to the rash ( although they did forward pictures to the dermatologist, no results yet.)
My CRP level is 3.5. I've had 4 nights of back and forth knee pain, more sever than in 2012. Today my left knee seems fine.. Crazy, crazy. Please advise......thank you in advance for your time.
We tested for Lyme Disease that came out negative. My sed rate was 77, and that was one month into it. We checked my sed rate periodically and it gradually returned to normal.
That was Summer 2012. The same thing has started again this week, February 2015. Same intermittent sore throat, rash on thighs, migrating intermittent knee pass. I went to the Doctor. Same confused reaction to the rash ( although they did forward pictures to the dermatologist, no results yet.)
My CRP level is 3.5. I've had 4 nights of back and forth knee pain, more sever than in 2012. Today my left knee seems fine.. Crazy, crazy. Please advise......thank you in advance for your time.
Brief Answer:
? Suspecting two possibilities for now
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I would go too hard on your doctor who was stumped as your presentation is one that should have matched a strep throat infection, directing us towards rheumatic fever. But as a strep throat was ruled out, we are left with very few options. Your doctor may not have looked for anything else other than Lyme's disease, which is why I would like to provide a short list of possibilities to be ruled out and would like you to take them up with your doctor and adequately rule out/diagnose them.
The list includes:
+Scarlet fever: Presents with a sore throat, rash, etc.
+Adult-onset Stills disease (AOSD): Presents with sore throat, fever, arthritis, rash, muscle pain, etc. Treated with infliximab, non-steroidal anti-inflammatory drugs, methotrexate, etc.
I understand the list of conditions provided is short, but I would like you to understand that your presentation is almost directly related to strep throat, and once that is ruled out we are left with nothing, taking us to a dead end. But I have given your symptoms some thought and have come up with these possibilities.
I would also like to add that initiation of antibiotic coverage would not do us too much harm, so you could take this up with your doctor as well ma'am. I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
? Suspecting two possibilities for now
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I would go too hard on your doctor who was stumped as your presentation is one that should have matched a strep throat infection, directing us towards rheumatic fever. But as a strep throat was ruled out, we are left with very few options. Your doctor may not have looked for anything else other than Lyme's disease, which is why I would like to provide a short list of possibilities to be ruled out and would like you to take them up with your doctor and adequately rule out/diagnose them.
The list includes:
+Scarlet fever: Presents with a sore throat, rash, etc.
+Adult-onset Stills disease (AOSD): Presents with sore throat, fever, arthritis, rash, muscle pain, etc. Treated with infliximab, non-steroidal anti-inflammatory drugs, methotrexate, etc.
I understand the list of conditions provided is short, but I would like you to understand that your presentation is almost directly related to strep throat, and once that is ruled out we are left with nothing, taking us to a dead end. But I have given your symptoms some thought and have come up with these possibilities.
I would also like to add that initiation of antibiotic coverage would not do us too much harm, so you could take this up with your doctor as well ma'am. I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Need to look for certain conditions to assume this to be urticaria or hives
Detailed Answer:
Hello once again ma'am.
If at all this could be urticaria or hives, then this is assumed to be allergic? Or the cause should be an infection, hepatitis, thyroid abnormalities, and rarely cancer. So all these causes will have to be looked into if we assume this to be urticaria or hives.
Please speak to your doctors about ruling out AOSD and Scarlet fever as well.
There is a lot more to be discussed and investigated until we can assume a diagnosis ma'am.
Need to look for certain conditions to assume this to be urticaria or hives
Detailed Answer:
Hello once again ma'am.
If at all this could be urticaria or hives, then this is assumed to be allergic? Or the cause should be an infection, hepatitis, thyroid abnormalities, and rarely cancer. So all these causes will have to be looked into if we assume this to be urticaria or hives.
Please speak to your doctors about ruling out AOSD and Scarlet fever as well.
There is a lot more to be discussed and investigated until we can assume a diagnosis ma'am.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Would Scarlet fever and AOSD still be candidates absent the fever ?
I just filled a prescription for anon-steroidal anti-inflammatory drug.
I have a hard time with the fact that the Doctors who saw my rash were not able to recognize it as hives. Are they many types of hives and is mine obviously not common? I would think that Doctors would see hives on a regular common basis.
The doctor even called in an Infectious Disease doctor that was present in the office and he didn't recognize this.
I will pass on your thoughts to the doctors. I just had 5 files of blood drawn and a urinalysis done. I know we were checking again for Lyme.
I just filled a prescription for anon-steroidal anti-inflammatory drug.
I have a hard time with the fact that the Doctors who saw my rash were not able to recognize it as hives. Are they many types of hives and is mine obviously not common? I would think that Doctors would see hives on a regular common basis.
The doctor even called in an Infectious Disease doctor that was present in the office and he didn't recognize this.
I will pass on your thoughts to the doctors. I just had 5 files of blood drawn and a urinalysis done. I know we were checking again for Lyme.
Brief Answer:
I can't begin to understand how troubling this must be for you :(
Detailed Answer:
Hello once again ma'am.
I can understand how this can be quite frustrating for you ma'am, and I am sincerely sad this is the current situation.
Sometimes, a fever is so mild that it may go unnoticed, making a diagnosis even more difficult.
Yes, I too was surprised when you mentioned your doctors were suspecting this to be hives? How is it that they are still suspecting it to be hives, and are not sure of it yet?! They would know by now, but let us give them the benefit of the doubt and wait to see what their thought process is, once the test results return, hopefully with more conclusive and helpful results.
If an infectious disease specialist could not recognise this, then this has to be something systemic (?possibly). Do discuss my possibilities as well, as they should look for all the options and rule them out.
Lyme's can at times not be in a stage where it can return a positive result, so checking for it again is not entirely wrong. Please do keep me updated, I would be more than happy to provide you with my opinion.
Best wishes.
I can't begin to understand how troubling this must be for you :(
Detailed Answer:
Hello once again ma'am.
I can understand how this can be quite frustrating for you ma'am, and I am sincerely sad this is the current situation.
Sometimes, a fever is so mild that it may go unnoticed, making a diagnosis even more difficult.
Yes, I too was surprised when you mentioned your doctors were suspecting this to be hives? How is it that they are still suspecting it to be hives, and are not sure of it yet?! They would know by now, but let us give them the benefit of the doubt and wait to see what their thought process is, once the test results return, hopefully with more conclusive and helpful results.
If an infectious disease specialist could not recognise this, then this has to be something systemic (?possibly). Do discuss my possibilities as well, as they should look for all the options and rule them out.
Lyme's can at times not be in a stage where it can return a positive result, so checking for it again is not entirely wrong. Please do keep me updated, I would be more than happy to provide you with my opinion.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
To explain hives-
My Doctor emailed me that after taking pictures of the rash and sending it to Dermatology, that they believe it to be polycyclic urticaria or hives.
Haven't gotten to speak with my Doctor about these yet but.
the following test results have come back -
cbc ( complete blood count ) all within range
A1c 5.8 ( was 5.9 9/10 )
throat culture usual flora 3+ epithelial cells no wbc sparse usual flora
ASO 32
Sed Rate 38
urinalysis within range trace hgb wbc 0-4 rbi 0-3
Anti inflammatory medicine definitely helped knee area. I'm having a slight off balance headache from it though. Going to ask my doctor if I can take half and half later.
Took 5 files of blood so there's probably more information in the works. I know of one more for sure- the Lyme screen.
Thank you for helping me with this. I couldn't get anyone to take me seriously in 2012, whereas it started away from home for 3 weeks, so the Doctors here did not see the rash and it had calmed down a bit when they finally got involved .
I appreciate looking at all angles because I want to be done with this. Thanks for your help.
My Doctor emailed me that after taking pictures of the rash and sending it to Dermatology, that they believe it to be polycyclic urticaria or hives.
Haven't gotten to speak with my Doctor about these yet but.
the following test results have come back -
cbc ( complete blood count ) all within range
A1c 5.8 ( was 5.9 9/10 )
throat culture usual flora 3+ epithelial cells no wbc sparse usual flora
ASO 32
Sed Rate 38
urinalysis within range trace hgb wbc 0-4 rbi 0-3
Anti inflammatory medicine definitely helped knee area. I'm having a slight off balance headache from it though. Going to ask my doctor if I can take half and half later.
Took 5 files of blood so there's probably more information in the works. I know of one more for sure- the Lyme screen.
Thank you for helping me with this. I couldn't get anyone to take me seriously in 2012, whereas it started away from home for 3 weeks, so the Doctors here did not see the rash and it had calmed down a bit when they finally got involved .
I appreciate looking at all angles because I want to be done with this. Thanks for your help.
Brief Answer:
We only see that there is some inflammation somewhere
Detailed Answer:
Hello once again ma'am.
I completely understand how you feel, waiting for conclusive results and going through so much just to reach a diagnosis can really test your patience, and I completely understand.
From the current reports provided ma'am, the only thing significant is the raised sedimentation rate, which indicates an inflammation somewhere. This test only helps indicate inflammation somewhere in the body, but it does not tell us where exactly this inflammation is.
I look forward to hearing from you ma'am. Hopefully we can find more conclusive results which will give us a way forward.
Best of luck ma'am, and you are in my prayers always.
We only see that there is some inflammation somewhere
Detailed Answer:
Hello once again ma'am.
I completely understand how you feel, waiting for conclusive results and going through so much just to reach a diagnosis can really test your patience, and I completely understand.
From the current reports provided ma'am, the only thing significant is the raised sedimentation rate, which indicates an inflammation somewhere. This test only helps indicate inflammation somewhere in the body, but it does not tell us where exactly this inflammation is.
I look forward to hearing from you ma'am. Hopefully we can find more conclusive results which will give us a way forward.
Best of luck ma'am, and you are in my prayers always.
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
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