Low grade fever & rash for 24 hours - ER doctor stumped!
May 17, 2017 6:23 PM   Subscribe

Every few months, the following thing happens to me: *low grade fever (about 100-101 degrees) which resolves within 24 hours, sometimes accompanied by mild chills/aches *large bright red rash on neck and middle of chest (flat, no pain or itching, blotchy appearence) which resolves within 48-72 hours *no other symptoms So far it has happened about 6 times total, extremely predictable.

I am never able to make an appointment with a dermatologist at the same time when I have the rash - by the time I see them it's gone. So last time this happened I went to the ER (fever was a little higher, 101.4) and the on call doctor examined me and did some blood and urine tests which came back normal, so he discharged me saying it was "idiopathic." Possible allergy or infection but nothing he knew of specifically.

Just wondering if others have experienced this or have any ideas! This last time (a few days ago) I sent photos to my primary care doctor, currently waiting for his reply.
posted by CancerSucks to Health & Fitness (14 answers total)
Not to be all WebMD you're gonna die, or anything, but I would ask some questions about Lyme disease.
posted by Autumnheart at 6:32 PM on May 17, 2017 [3 favorites]

Google image search "viral exanthem"
posted by treehorn+bunny at 7:37 PM on May 17, 2017 [3 favorites]

OK, I am probably overgeneralizing here but a possibly relevant personal experience.

About 10 years ago I had something vaguely similar including rash, went to a dermatologist who said "probably nothing" but proceeded to order a test for a rare chronic disease. It came back positive, they gave no advice other than "see a specialist" Even when I asked a specific question whether I, in particular, was probably at risk for a false positive for reasons (I was).

I basically lost a summer because it took months to get the appointment and battery of follow up tests, and preventive measures for the disease I didn't end up having included avoiding the sun. It also broke a lot of good habits I had at that time in terms of physical exercise, plus of course the stress.

Medical-field friend afterwards claimed dermatologists were a field where the bulk of their money was from cosmetic procedures and basically "blindly test and pass on to someone else" was all that'd happen.

Not going to share my non-disease because the whole point was the stress and misdiagnosis was horrible and avoidable. And my friend's advice could be wrong but I would consider a GP. If the rash does have an underlying cause you need to know about it's probably not primarily a skin condition (as in for example Lyme disease mentioned above.)
posted by mark k at 8:45 PM on May 17, 2017 [4 favorites]

Having had a variation of this happen to me at irregular intervals over many years, it sounds like a possible autoimmune flare of some sort. I suggest suggest that you talk to your primary care doc about seeing a rheumatologist next, rather than a dermatologist. Even if you're not actively experiencing the fever/rash/etc. when you see the rheumatologist, it would be useful for them to have your medical history, so that you can become an established patient and contact them as soon as the next flare happens -- since you report that it's so fleeting, they may be willing to let you make a last minute appointment in order to catch it while it's active.
posted by the return of the thin white sock at 9:38 PM on May 17, 2017 [7 favorites]

Have you been anywhere you could have picked up malaria?
posted by bq at 11:15 PM on May 17, 2017

I was tested negative for Lyme about 3 years ago after my only trip to a tick-heavy area. Never been somewhere where malaria exposure would be a concern.

I am curious about other autoimmune possibilities - what are the major ones that match my symptoms?

My primary care doc just emailed back saying I could come in next time it happens, he had no idea based on the photos of the rash that I sent. The exact word he used was "weird" !!!

I just spoke to my mother who told me that as a child I would get the same rash (blotchy red on chest/neck) a few days before a cold or a flu. As an adult there are no cold/flu symptoms though. But this makes me suspect it is viral?
posted by CancerSucks at 12:40 AM on May 18, 2017

Scarlet fever (basically, strep with a rash), maybe? Next time it happens, it couldn't hurt to have your GP do a strep test.
posted by merejane at 6:41 AM on May 18, 2017

When you say it happens every few months, 6 times total, does that mean every two months for a year, every 4 months for three years, etc? Because it sounds like you just get a rash as a symptom of a regular old virus.
posted by pintapicasso at 8:36 AM on May 18, 2017 [2 favorites]

Sorry, I should have added - I know several people this happens to (me!)
posted by pintapicasso at 8:38 AM on May 18, 2017

Derm nurse here --- did you say you had photos? Would you be comfortable sharing?

Your description almost exactly lines up with people who come in and have Urticaria (Hives). One of the big characteristics of urticaria is that it comes up, and resolves usually within 24 hours. They are usually intensely itchy. What is less easy to nail down is the cause. For some people it can be a systemic allergy? Some something they come into contact with? For some even just pressure or heat can cause them to come up. More common than not, we don't have any idea why they come up, just that they do (which we would usually call "idiopathic" urticaria)

Now, what to do about it? Well that's typically pretty easy. If you have them come up relatively regularly we always suggest taking daily antihistamines, whether you are having symptoms or not. If you continue to break through and have them, increase to taking them twice a day (morning and night) despite symptoms, until you stop having the rash come up. You can increase to up to 4 antihistamines a day. We usually recommend either Claritin, Allegra, or Zyrtec OTC as they tend to not cause as much drowsiness.
posted by Quincy at 10:13 AM on May 18, 2017

I "know someone" who had weird fevers for months. Turned out it was Crohn's. Found it through a random CT scan. May want to ask your doctor about that possibility. Crohn's is odd and produces the most random symptoms, since it involves your immune system.
posted by Pacrand at 4:21 PM on May 18, 2017

In regards to the suggestion of urticaria, those have a very typical appearance (compare the Google image search to the viral exanthem I mentioned) and are not usually accompanied by fever, chills, or body aches.

Hives are part of an allergic reaction and may be accompanied by itching, shortness of breath, swelling of the tongue, mouth, or throat, or dizziness/fainting.

Your symptoms are what medical folks call "nonspecific" which means that they occur with many different illnesses. Basically any viral infection can cause symptoms like this, although a number of other things can as well. Speculating about it on the internet is probably more likely to scare you (it could be cancer!) than to give you helpful ideas.
posted by treehorn+bunny at 6:03 PM on May 18, 2017

What kind of cancer did you have? Still having chemo or radiotherapy for it?
posted by Stephanie_Says at 5:46 AM on May 19, 2017

Toxicologist chiming in: are you taking vitamin supplements, specifically vitamin A? Skin rashes (and headaches) are pretty classical signs and symptoms of vitamin A toxicity, and a straightforward full blood panel would get to the bottom of it.
posted by late afternoon dreaming hotel at 8:47 AM on May 19, 2017

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