[38F] Experiencing chest pain, random bruises, and transient rashes

Patient Description

A 38-year-old female presents with sharp chest pain on the left side under the breast, exacerbated by coughing, and rates the pain as a 7 out of 10. The pain occasionally radiates upwards with intense coughing. For the past week, she has also noticed random quarter-sized bruises on her arms and legs without any known trauma. Additionally, she reports red, non-itchy, non-raised rashes on her arms and chest that last 12-24 hours before resolving. She experiences difficulty breathing but has a long-standing history of low-grade fevers. Joint pain is present in her hands and arms. She is currently taking Pantoprazole Sodium and has a known allergy to Tramadol. She was previously on antibiotics and anti-inflammatory medication for chest inflammation, which were ineffective. The patient is also under investigation for possible Crohn's disease or IBD, with symptoms starting around early 2023. No recent travel, exposure to new environments, or contact with individuals with similar symptoms has been reported.

Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

Infection: An infection can cause symptoms like fever, rash, and bruising. However, it's less likely given the duration of your symptoms.
- Treatment typically involves antibiotics or antiviral medications, depending on the cause of the infection.
Autoimmune disease: Conditions like lupus or rheumatoid arthritis can cause a variety of symptoms, including rash, joint pain, and unexplained bruising. These conditions occur when your immune system mistakenly attacks your own body.
- Treatment usually involves medications to suppress the immune system and reduce inflammation.
Blood clotting disorders: Conditions that affect the clotting of your blood can cause unexplained bruising and rash. These conditions can be inherited or acquired.
- Treatment typically involves medications to prevent blood clots.
Vasculitis: This is inflammation of the blood vessels, which can cause rash, joint pain, and unexplained bruising.
- Treatment usually involves medications to reduce inflammation.

Please note that these are possibilities based on the information you provided and not a definitive diagnosis. You should seek care from a healthcare professional for a formal diagnosis and treatment.

What you can do

Schedule an appointment with your healthcare provider as soon as possible to discuss your symptoms. They may want to run some tests to help determine the cause of your symptoms.
Keep track of your symptoms. Note when they occur, how long they last, and any potential triggers. This information can be helpful for your healthcare provider.
Try to rest and stay hydrated. These general health measures can help your body cope with whatever is causing your symptoms.