[31F] With neck rash, swollen lymph nodes, and headache

Patient Description

A 31-year-old female presents with a neck rash described as a long, red streak that is dry and itchy, which has been present for 3 days and is being treated with cortisone. She also reports swollen, tender, painful, and enlarged lymph nodes near her armpits, a stiff neck characterized by tightness, and an aching headache behind the left eye rated 7/10 in severity. The headache has been on and off for a few weeks, exacerbated by noise, computer use, and bright lights. The patient has a history of HSV1 diagnosed a year ago and is taking Valacyclovir intermittently. No known allergies or other medications reported. No recent injuries or accidents have been noted.

Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible conditions that could be causing them:

Infectious Mononucleosis (Mono): Often caused by the Epstein-Barr virus, Mono can cause symptoms such as a rash, swollen lymph nodes, and a stiff neck. It's often accompanied by fatigue, fever, and a sore throat.
- Treatment typically involves rest, hydration, and over-the-counter remedies for pain and fever.
Lyme Disease: This is a bacterial infection transmitted by ticks. Early symptoms can include a rash (often described as a "bull's-eye" rash), headache, and neck stiffness.
- Treatment for Lyme disease usually involves antibiotics.
Meningitis: This is an inflammation of the membranes surrounding your brain and spinal cord. Symptoms can include a stiff neck, headache, and a rash. It's a serious condition that requires immediate medical attention.
- Treatment depends on the type of meningitis but often involves antibiotics or antiviral medications.

Please note that these are just possible conditions and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms and medical history to provide an accurate diagnosis.

What you can do

Given the severity and combination of your symptoms, it's important to seek medical attention as soon as possible. Here are some steps you can take:

Schedule an appointment with your primary care provider. If you can't get an appointment soon, consider going to an urgent care clinic.
Be prepared to discuss your symptoms in detail, including when they started, what makes them better or worse, and any other associated symptoms.
Continue to monitor your symptoms and take note of any changes or new symptoms.