Dr. Ashaq Hussain Parrey
Rheumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 32 year old woman. I weigh 149.91 Ibs. I am suffering from fever since one month. Almost daily the temperature is ranging from 99 to 101. Especially in the afternoon. I also have a headache along with fever. Both increases together. Also, there is severe pain in the muscles of the legs below the knee to ankle. The muscles behind the knee (underside of the knee) ache more, and it increases in the evening or night times. I have normal regular home cooked vegetarian food. I have shifted to a new city three months back. Before, I used to exercise, do yoga and walk regularly. But now due to a new place, it is discontinued. I have undergone all tests, and they are normal. Kindly advise.
Hello,
Welcome to icliniq.com.
I went through your reports (attachment removed to protect patient identity). Your primary complaint is a fever, especially during the afternoon hours. Your LFT (liver function test) is revealing transaminitis. Rest of the investigations which you have posted are normal. I would suggest a few things:
Start a broad spectrum antibiotic (like Cefuroxime 500 mg twice daily) after a blood culture and come back with investigations.
Regards.
Patient's Query
Thank you doctor,
The ESR test is already done and I am attaching the reports. The fever is not normalizing even if I take a Paracetamol tablet. What could be the reason of leg muscle pain which is more troubling than fever?
Hello,
Welcome back to icliniq.com.
Your ESR is very high and one thing we have to rule out is an autoimmune disorder, for which do ANA HEp-2 test. The muscle pain is due to inflammatory markers like high ESR, and other interleukin released from the inflammatory site. Instead of Paracetamol, I would suggest you take Naproxen 500 whenever needed.
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Rheumatology
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