[33F] Experiencing widespread petechiae and various systemic symptoms

Patient Description

A 33-year-old female presents with widespread petechiae that appeared yesterday morning and have increased in number. Accompanying symptoms include intermittent chest discomfort on the right side, exhaustion, dizziness, intermittent pressure on the left side of the abdomen and at times the back, and achy joints. The dizziness is described as lightheadedness, rated 3/10 in severity, and is exacerbated by standing up quickly or moving around a lot. The chest discomfort is a dull pain, rated 4/10, located on the left side beneath the ribs and started today. The abdominal pressure has been on and off for months, described as crampy with pressure, and is accompanied by heartburn, which occurs daily, multiple times a day, especially after eating. The patient also reports sporadic achy joints, particularly in the hips, right elbow, and right shoulder, described as a dull ache, rated 2/10 in severity, and has been present for a couple of weeks. The patient has been experiencing a dull ache across the lower back, also for a couple of weeks. Additional symptoms include headaches, constant fatigue, and night sweats. The patient has lost about 5 pounds over the past few months, despite having an inconsistent appetite. The patient has a history of migraines, diagnosed at age 22, and is currently taking 20 mg Prozac and 30 mg Vyvanse, with occasional use of Ibuprofen, Tums, and Midol. The patient has allergies to penicillin and bee venom. No new medications or changes in dosage have been reported recently.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possible explanations for your symptoms:

  • Vasculitis: This is inflammation of the blood vessels, which can cause petechiae. Symptoms can include fatigue, weight loss, and joint pain. Vasculitis can affect any of the body's blood vessels.

    • Treatment typically involves medications to reduce inflammation and suppress the immune system.
  • Thrombocytopenia: This is a condition characterized by low platelet counts, which can lead to petechiae. It can be caused by a variety of conditions, including certain medications, infections, or autoimmune diseases.

    • Treatment depends on the underlying cause and may include medications, blood transfusions, or procedures to remove the spleen.
  • Infectious Mononucleosis (Mono): This is a viral infection that can cause symptoms such as fatigue, sore throat, fever, and skin rash. It can also cause an enlarged spleen, which might explain your abdominal discomfort.

    • Treatment typically involves rest, hydration, and over-the-counter remedies for pain and fever.
  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that affects the ring of muscle between your esophagus and your stomach. This could explain your heartburn and chest discomfort.

    • Treatment typically involves lifestyle changes and over-the-counter medications. Prescription medications and surgery are also options for more severe cases.

Please note that these are potential explanations and not a definitive diagnosis.

What you can do

Given the widespread nature of your symptoms and the sudden appearance of petechiae, it's important to seek medical attention promptly. Here are some steps you can take:

  1. Schedule an appointment with your primary care doctor as soon as possible. If you can't get an appointment soon, consider going to an urgent care clinic.
  2. Write down all of your symptoms, including when they started and any patterns you've noticed. This will help your doctor in diagnosing your condition.
  3. Make a list of all the medications and supplements you're currently taking, including doses and how often you take them. Don't forget to include over-the-counter medications.
  4. Stay hydrated and try to rest as much as possible.

What you should look out for

Seek immediate medical attention if you experience:

  • Difficulty breathing or shortness of breath
  • Severe abdominal pain
  • Blood in your stool or urine
  • A severe headache or a headache that is different from your usual migraines
  • A fever over 100.4°F
  • Any new or worsening symptoms

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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1 yr ago

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People Also Ask


What are petechiae and what causes them?

Petechiae are small, red or purple spots on the skin caused by bleeding under the skin. They can be caused by a variety of conditions, including infections, certain medications, or low platelet counts.


How can vasculitis affect the body and what are its symptoms?

Vasculitis is inflammation of the blood vessels, which can lead to symptoms such as fatigue, weight loss, joint pain, and skin rashes. It can affect any blood vessels in the body, potentially leading to organ damage if not treated.


What is thrombocytopenia and how is it treated?

Thrombocytopenia is a condition characterized by low platelet counts, which can lead to easy bruising and bleeding, including petechiae. Treatment depends on the underlying cause and may include medications, blood transfusions, or procedures like splenectomy.


What lifestyle changes can help manage GERD symptoms?

To manage GERD symptoms, lifestyle changes such as avoiding trigger foods, eating smaller meals, not lying down immediately after eating, losing weight if overweight, and elevating the head of the bed can be helpful. Over-the-counter medications may also be used to reduce stomach acid.


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