[21F] With persistent headaches and facial petechiae

Patient Description

A 21-year-old female presents with tiny red and purple dots around her eyes and eyebrows, which have been spreading to the other side of her face over the past month. She reports accompanying symptoms of fevers and severe throbbing headaches, rated 7 out of 10 in intensity, lasting approximately 5 hours each episode. The headaches are not relieved by any measures and are not associated with specific triggers. Additionally, the patient experiences fatigue but denies any unusual bleeding, bruising, unexplained weight loss, or night sweats. She has not started any new medications or supplements, nor has she traveled or been exposed to new substances recently. Her medical history includes concussions, an eye infection, and resolved Bell's palsy from 1-2 years ago. She is currently taking Tylenol for symptom relief. No known drug allergies were reported.

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Arora's Assessment

What might be happening

Your symptoms could be related to several conditions:

  1. Petechiae: The tiny red and purple dots around your eyes and eyebrows might be petechiae, which are small blood vessels that have burst. This can be caused by various factors, including infections, physical strain, or a reaction to medication.

  2. Viral Infection: The combination of fever, headaches, and fatigue could suggest a viral infection. These symptoms are common in many viral illnesses.

  3. Autoimmune Conditions: Conditions like lupus can cause skin changes, fatigue, and headaches. However, more specific tests are needed for diagnosis.

  4. Other Causes: Given your history of concussions and eye problems, it's important to consider if these might be contributing to your current symptoms.

What you can do

  • Seek Medical Attention: It's important to see a healthcare provider for a thorough evaluation. They may recommend blood tests or imaging to determine the cause of your symptoms.

  • Symptom Management: Continue taking Tylenol for fever and headache relief, but follow the recommended dosage. Rest and stay hydrated to help your body recover.

  • Track Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.

What you should look out for

  • Worsening Symptoms: If you notice increased spreading of the spots, new symptoms like unusual bleeding, or if your headaches become more severe, seek medical care promptly.

  • New Symptoms: Be alert for any new symptoms such as joint pain, swelling, or changes in vision, and report these to your healthcare provider.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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1 mo ago

People Also Ask


What are petechiae and what causes them?

Petechiae are small red or purple spots on the skin caused by minor bleeding from broken capillary blood vessels. They can be caused by infections, physical strain, or reactions to medications.


Could my symptoms be related to a viral infection?

Yes, the combination of fever, headaches, and fatigue is common in many viral infections. It's important to monitor your symptoms and consult a healthcare provider for a proper diagnosis.


How can autoimmune conditions like lupus cause these symptoms?

Autoimmune conditions like lupus can cause a variety of symptoms, including skin changes, fatigue, and headaches, due to the immune system attacking the body's own tissues. Specific tests are needed for diagnosis.


What should I do if my symptoms worsen or new symptoms appear?

If your symptoms worsen, such as increased spreading of the spots or more severe headaches, or if you develop new symptoms like unusual bleeding or joint pain, seek medical care promptly. It's important to keep your healthcare provider informed of any changes.


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