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Fever between 99.6 to 102.6 on 21 year old male. Red

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Fever between 99.6 to 102.6...
Fever between 99.6 to 102.6 on 21 year old male. Red blotches on torso, groin, around eye, & back after fever gone. Emergency claims viral with fever. After blotches doctor sent for blood work. Blotches large, medium, small ovals and not raised. Seems to be spreading.
Submitted: 8 years ago.Category: Medical
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6/28/2010
Doctor: Dr Uzair, Doctor replied 8 years ago
Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 10,527
Experience: MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
Verified

Hi.
Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.

From the symptoms you have listed above it seems to be typical of a Viral illness, most likely measles. Measles presents with a barking cough and high grade fever with eventual development of a rash which is macular that is, red and flat lesions on the skin.

Other viral illnesses that can cause such a rash in his age group are infectious mononucleosis but there is usually a enlargement of lymph nodes in the neck and the rash does not appear if antibiotics have not been mistakenly used.

Viral attacks like measles are self limiting and usually subside completely in two weeks.

Treatment is symptomatic with use of anti pyretics and anti inflammatory drugs like Tylenol 2 tablets 4-6 hourly per oral and good hydration as fever promotes insensible water loss from the body surfaces. If the patient appears to be dehydrated; dry tongue, sunken eyes, lack of urine, the use of oral rehydration liquids like Gatordae and Pedialyte are recommended, if the patient is vomiting due to the fever and the viral illness then take to an Urgent Care Centre for IV hydration.

If fever is persistent and bothersome and does not subside with the anti pyretic medication then cold sponging with fanning is a good option and usually relieves the fever in 10 to 15 mins, provided it is done correctly.

None the less, wait for the blood work which will rule out bacterial infections and treat the patient symptomatically as advised.

--Best wishes--

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Customer reply replied 8 years ago
Reviewed your answer and feel you may need to know more. My son has not had a barking cough. The rash came after the fever stopped and goes from his groin to his head (circled around eye). It does not itch and is not bumpy in any way but seems to spread. During the fever (6-7 days), he experienced severe headaches, sweats, chills, lack of appetite and neck stiffness (not severe). He took soaks in the tub, took Ibprophenol (800 mg). He slept alot because he was so tired and weak. The hospital took tests and said he was dehydrated and gave him an IV. Blood work & x-rays showed nothing. Thats when the said it was more than likely viral. Once the fever broke and the rash started appearing, took him to our regular MD and he said the rash was "Impressive" and sent him for blood work. We did not get the results yet but the rash is still there and spreading. Do you still think what you said is true?
Doctor: Dr Uzair, Doctor replied 8 years ago

The whole story did twist the scenario a bit, but I can say with all surety that he has had a viral attack, which has now entered the convalescent phase (recovery) that's why the rash.

Viral infections have different ways of presentation and different patterns of rash but they have symptoms typical to each other. The neck stiffness however, shows an element of viral meningitis, which needs to be ruled.

The management however, does not change with viral illnesses and the same regimen for symptomatic relief is applied in every viral illness and the rest is left for the body to defend itself against the viral infection.

However, it is very difficult to come to a definate pin point diagnosis on the internet and without a clinical examination.

I suggest you wait for the attack to settle down and the lab results to come.

--Best--

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Customer reply replied 8 years ago
We were just notified that the blood tests showed positive for Lyme's Disease. If he previously had Lyme's and was treated and released about 8 years ago, could this show up on his latest test as a positive?????? Seems to me the symptoms were pretty severe for a flair up..... Also, isn't Lyme Disease bacterial in nature not viral? Upon reading on-line about Lyme Symptoms, it mimics alot of what the Neuroligist diagnosed as Minere's Disease (excuse spelling). Could it have been Lyme Disease never diagnosed correctly? Also, no one else has been sick as a result of what he has or have had.
Doctor: Louise Sivak, M.D., Doctor replied 8 years ago
Louise Sivak, M.D.
Category: Medical
Satisfied Customers: 3,499
Experience: Pediatrician, Board-certified in Hematology/Oncology
Verified

Hello,

I am sorry your son has been ill.

I assume the tests done recently that show Lyme are antibody titers that prove recent infection. A prior infection may be present but cannot be dated as to when it happened.

Lyme disease is caused by a bacterium, not a virus.

Your son needs treatment with an antibiotic and follow-up with a neurologist to make sure his symptoms resolve fully.

Lyme is not contagious ; it is a tick-borne illness.

Hope this helps some and please tell me what other questions you have.

Best,

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Customer reply replied 8 years ago
What you are saying then is this is a recent Lyme problem and the illness he has had for the last 4 years is not related to the Lyme. Thus, we should still try to determine for sure if it is Meniere's Disease. We are not convinced that it is Meniere's because the meds he was given doesn't help him. We have taken him to an eye, ear, nose specialist to confirm it is not pressure on his inner ear and he is scheduled to have an MRI with contrast. I was thinking maybe it was the Lyme Disease all along.
Doctor: Louise Sivak, M.D., Doctor replied 8 years ago

Hello,

I agree with your and your son's doctor's plan.

Unfortunately Meniere's can be difficult to diagnose and very difficult to treat.

Best of luck,

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Customer reply replied 8 years ago
Once the Lyme Disease is treated and, if his 4-year problems persist and, his MRI shows nothing, would your next step be another Neurologist or an Infectious Disease Doctor? As you can probably tell, we are not too happy with the current Neurologist.
Doctor: Louise Sivak, M.D., Doctor replied 8 years ago

Hello,

In that case I'd recommend you get a second opinion from another pediatric neurologist.

Louise Sivak, M.D.
Category: Medical
Satisfied Customers: 3,499
Experience: Pediatrician, Board-certified in Hematology/Oncology
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