[35F] Experiencing multisystem symptoms including hand swelling and neurological issues

Patient Description

A 35-year-old female presents with a complex array of symptoms including a burning sensation and major swelling in the hands that persists throughout the day, with the swelling being particularly severe in the mornings. The patient reports a recent episode of near fainting accompanied by blurred vision, dizziness, and slurred speech. Additionally, there is an infected pocket in the mouth on the gums due to an abscessed tooth, which is scheduled for extraction. The patient experiences throbbing headaches predominantly at night, with a severity rating of 8 out of 10, and these headaches are localized to the right side. There is also a report of delirium, confusion, and exhaustion. The patient has a history of Hepatitis C diagnosed five years ago and is currently on Wellbutrin and Seroquel. No known drug allergies are reported. The patient has experienced fever episodes twice in the past two weeks and has a history of sepsis. There is no family history of rheumatologic or autoimmune conditions, and no other medications are being taken.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Infection: The swelling, pain, and warmth in your hand, along with the infected abscessed tooth and history of sepsis, suggest a possible ongoing infection. Infections can cause a variety of symptoms, including fever, confusion, and a general feeling of being unwell.

    • Treatment typically involves antibiotics to fight the infection. In some cases, surgical intervention may be necessary (like tooth extraction for an abscessed tooth).
  • Neurological conditions: The sudden blurred vision, loss of balance, confusion, and difficulty speaking could be symptoms of a neurological condition, such as a transient ischemic attack (TIA) or stroke. However, these are serious conditions that typically require immediate medical attention.

    • Treatment depends on the specific condition and could range from medication to surgery.
  • Carpal Tunnel Syndrome or other peripheral neuropathy: The numbness, burning, and pain in your hand and fingers could be due to a nerve-related condition, such as carpal tunnel syndrome or another type of peripheral neuropathy.

    • Treatment typically involves managing symptoms and addressing the underlying cause, if known. This could include physical therapy, medication, or in some cases, surgery.

Please note that these are potential explanations based on the symptoms you've described, but they are not definitive diagnoses. It's important to consult a healthcare professional for an accurate diagnosis and treatment.

What you can do

  1. Seek immediate medical attention: Given the severity and sudden onset of some of your symptoms (such as blurred vision, loss of balance, and confusion), it's crucial to seek immediate medical attention. These could be signs of a serious condition that requires prompt treatment.

  2. Consult a healthcare professional about your hand symptoms: If you haven't already, consider seeing a healthcare professional about the pain, swelling, and numbness in your hand. They can provide an accurate diagnosis and appropriate treatment.

  3. Follow up on your dental treatment: Ensure you follow through with your planned dental treatment for the abscessed tooth. If the infection is causing some of your symptoms, treating the source could provide relief.

What you should look out for

  • Worsening of symptoms: If your symptoms worsen or if you develop new symptoms, seek medical attention immediately. This includes increased pain or swelling, higher fever, worsening confusion, or new neurological symptoms (like weakness on one side of the body).

  • Signs of a severe infection or sepsis: Given your history of sepsis, it's important to be aware of the signs of a severe infection or sepsis. These can include high fever, rapid heart rate, difficulty breathing, extreme pain or discomfort, and a change in mental status (like confusion or disorientation).

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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10 mo ago

People Also Ask


What could cause a burning sensation and swelling in the hands, especially in the morning?

A burning sensation and swelling in the hands, particularly in the morning, could be due to conditions like carpal tunnel syndrome, arthritis, or an inflammatory response. It's important to consult a healthcare professional for an accurate diagnosis.


What are the potential causes of sudden blurred vision, dizziness, and slurred speech?

Sudden blurred vision, dizziness, and slurred speech could be symptoms of a transient ischemic attack (TIA) or stroke, which are serious conditions requiring immediate medical attention. Other potential causes include migraines or neurological disorders.


How can an abscessed tooth affect overall health and what are the treatment options?

An abscessed tooth can lead to a localized infection that may spread, causing systemic symptoms like fever and fatigue. Treatment typically involves antibiotics and dental procedures such as drainage or extraction of the affected tooth.


What are the signs and symptoms of a severe infection or sepsis that one should be aware of?

Signs of a severe infection or sepsis include high fever, rapid heart rate, difficulty breathing, extreme pain or discomfort, and changes in mental status like confusion or disorientation. Immediate medical attention is crucial if these symptoms occur.


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