[20M] With severe Achilles pain, rash, and fever

Patient Description

A 20-year-old male presents with severe pain in the Achilles tendon, a non-itchy rash characterized by small, flat circles around the ankles, on the arms, knees, and hamstrings, as well as an intermittent fever ranging from 100-103°F persisting for five days. The rash does not change with food intake and has not been observed in others around the patient. The patient has not traveled recently nor been in contact with anyone with similar symptoms. No interventions for the rash have been reported, but unspecified measures have been taken to manage the fever. The patient has not been tested for Covid-19 during this period.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Viral Infection: Your fever and rash could be due to a viral infection. Some viruses can also cause joint pain. Examples include Parvovirus B19 (which causes Fifth disease) and some types of enteroviruses.

    • Treatment: Viral infections usually resolve on their own within a week or two. Rest, hydration, and over-the-counter medications to manage fever and pain can help.
  • Reactive Arthritis: This is a type of arthritis that occurs as a "reaction" to an infection in another part of your body. It can cause joint pain and swelling, as well as skin rashes.

    • Treatment: Reactive arthritis often resolves on its own, but your doctor may recommend medications to relieve your symptoms and possibly treat the underlying infection.
  • Lyme Disease: If you've been in an area with ticks, Lyme disease could be a possibility. It can cause a rash (often but not always in a bull's-eye pattern), fever, and joint pain.

    • Treatment: Antibiotics are used to treat Lyme disease.

Please note that these are just possibilities, not a definitive diagnosis. You should seek care from a health professional for a formal diagnosis and treatment.

What you can do

  1. Rest and stay hydrated. This can help your body fight off an infection if that's what's causing your symptoms.
  2. Over-the-counter pain relievers can help with your Achilles pain and fever. Follow the instructions on the package.
  3. Avoid scratching your rash, as this can lead to infection.

What you should look out for

You should seek immediate medical attention if:

  • Your fever rises above 103°F or lasts more than a few days.
  • You have severe pain or swelling in your Achilles tendon.
  • You notice a bull's-eye rash (a sign of Lyme disease).
  • You have other symptoms that concern you.

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9 mo ago


People Also Ask


What could be causing a non-itchy rash with fever and joint pain?

A non-itchy rash with fever and joint pain could be caused by a viral infection, reactive arthritis, or potentially Lyme disease if you've been in an area with ticks. It's important to consult a healthcare professional for an accurate diagnosis.


How can I manage symptoms of a viral infection at home?

To manage symptoms of a viral infection at home, ensure you get plenty of rest, stay hydrated, and use over-the-counter medications to relieve fever and pain. These measures can help your body recover.


What are the signs that I should seek immediate medical attention for my symptoms?

You should seek immediate medical attention if your fever rises above 103°F, lasts more than a few days, if you experience severe pain or swelling in your Achilles tendon, notice a bull's-eye rash, or have other concerning symptoms.


Could my symptoms be related to Lyme disease even if I haven't traveled recently?

Even if you haven't traveled recently, Lyme disease could still be a possibility if you've been in an area where ticks are present. It's important to consider your recent activities and consult a healthcare provider for testing if necessary.

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