[47F] With painful lower leg swelling, joint pain, and systemic symptoms

What might be happening

Based on the symptoms you’ve described—sharp, stabbing pain in your lower left leg and foot, redness, warmth, swelling, streaking, fever, chills, enlarged lymph nodes, and joint pain—there are a few possible explanations for what might be happening:

1. Cellulitis: This is a bacterial skin infection that causes redness, warmth, swelling, and pain. The streaking you mentioned could indicate that the infection is spreading through your lymphatic system. Fever, chills, and swollen lymph nodes are common signs of a more severe or systemic infection. Cellulitis often requires prompt treatment with antibiotics to prevent complications.

2. Lymphangitis: This is an infection of the lymphatic vessels, often caused by bacteria spreading from a nearby skin infection (such as the infected hair follicle you mentioned). It can cause red streaks, fever, and swollen lymph nodes, similar to what you’re experiencing. This condition is serious and requires immediate medical attention.

3. Septic Arthritis or Reactive Arthritis: The sudden onset of pain and swelling in random joints, along with fever, could suggest an infection in the joints (septic arthritis) or an inflammatory reaction triggered by an infection elsewhere in the body (reactive arthritis). These conditions can cause significant joint damage if not treated promptly.

4. Deep Vein Thrombosis (DVT): While less likely given the redness and warmth, a blood clot in the deep veins of your leg can cause pain, swelling, and redness. This is a serious condition that requires immediate evaluation to prevent complications like a pulmonary embolism.

5. Autoimmune or Systemic Conditions: Conditions like vasculitis, lupus, or other autoimmune diseases could potentially explain the combination of joint pain, systemic symptoms (fever, chills), and skin changes. However, these are less likely given the acute nature of your symptoms.

Typical Testing and Treatment

• For cellulitis or lymphangitis: Your doctor may perform a physical exam and start you on antibiotics. Blood tests or imaging (like an ultrasound) may be done to rule out deeper infections or blood clots.
• For joint pain: If septic arthritis is suspected, your doctor may order blood tests, joint fluid analysis, or imaging like X-rays or MRIs.
• For DVT: An ultrasound of your leg may be performed to check for blood clots.
• For systemic conditions: Blood tests to check for markers of inflammation or autoimmune activity may be ordered.

What you can do

For your lower leg pain, redness, and swelling:

• Seek medical attention immediately. The combination of redness, warmth, streaking, fever, and swollen lymph nodes suggests a serious infection like cellulitis or lymphangitis, which requires prompt treatment with antibiotics.
• While waiting to see a doctor, you can:
  • Elevate your leg: Keep your leg elevated above the level of your heart to reduce swelling.
  • Avoid pressure: Do not apply pressure or massage the area, as this could worsen the condition if a blood clot is present.
  • Stay hydrated: Drink plenty of fluids to support your immune system.
  • Avoid walking or standing for long periods: Rest your leg to prevent further irritation.

For your joint pain and swelling:

• Document which joints are affected, how long the pain lasts, and any patterns you notice. This information will help your doctor determine if the joint pain is related to an infection or another condition.
• Avoid activities that worsen the pain, and consider using ice packs on swollen joints for short periods to reduce inflammation.

For your canker sores and infected hair follicle:

• Continue using warm compresses on the infected hair follicle, as it seems to be improving. If it worsens or starts draining pus, let your doctor know.
• For canker sores, you can:
  • Rinse your mouth with a saltwater solution or a baking soda rinse to reduce irritation.
  • Avoid spicy or acidic foods that can worsen the pain.
  • Use over-the-counter topical treatments like benzocaine gels to numb the sores.

Track your symptoms:

• Use MDandMe to journal your symptoms, including the severity of your leg pain, any changes in redness or swelling, and the progression of your fever or chills. This will help your doctor understand how your condition has evolved over time.

What you should look out for

Seek immediate medical care if you experience any of the following:

• Worsening redness, swelling, or streaking in your leg.
• Increased pain or inability to move your leg or foot.
• High fever, chills, or feeling faint.
• Shortness of breath, chest pain, or sudden swelling in other areas (which could indicate a blood clot).
• New or worsening joint pain, especially if accompanied by redness or warmth in the joint.

Your symptoms are concerning for a potentially serious condition, and it’s important to get evaluated as soon as possible. If you feel your condition is worsening or you’re unable to see a doctor promptly, go to the nearest emergency room. Let me know if you’d like help preparing for your visit or summarizing your symptoms for your doctor.