Prodromal Symptoms

Dear Dr. Rob:

Hi I hope you can help me. About 2 1/2 years ago I had gotten an infection on my thumb. My initial symptoms began approx 2-3 weeks before the actual rash emerged. I experienced total fatigue, soreness of my skin over my entire body, almost to the extreme of not being able to wear clothing. I had general muscle aches and pains as well as headaches and chills. A few days before the rash showed, I had pain in my thighs, buttocks, and legs, as well as a constant pain in my arm that progressed into a radiating pain going from my thumb up into my arm. I was in such severe pain that I ended up in the ER. I was first diagnosed with shingles. The ER doctor prescribed Valtrex for 10 days and Bextra for the inflammation. About 3 days into this treatment I fell into worse health. I experienced acid reflux and stomach pains, which turned into vomiting, and then I noticed a red streak going from my thumb half way up my arm. Again I was rushed to the same ER in such intense pain that I was crying my eyes out. The ER doctor did some further research and said that it could possibly be a herpes infection. I would have to assume from my research that he meant whitlow. He prescribed Keflex and told me to remain on the other meds as well. It took about 3 weeks for my thumb to finally heal. Soon after I was presented with a whole new host of issues, now gynecologically. I guess from all the antibiotic I now had a yeast infection. I saw my GYN and they treated it with cream and suppositories. But then this started a vicious cycle. After this treatment concluded I ended up with bacterial vaginosis and was treated with metrogel. Then a few days later another yeast infection arose. Same treatment as before…and again another bacterial vaginosis infection followed.

This went on for months and I was in so much pain from all the treatments destroying my skin that all my nerve endings were exposed. The burning was so intense that I couldn’t even wear underwear or sit for that matter. I finally saw an infectious disease GYN specialist. He took me off all meds and treatments from the previous doctors and prescribed topical xylacaine and amitriptyline. I was on this treatment for months as well and things finally started looking favorable for me (except for gaining 40+ lbs from the antidepressant). I eventually went off all meds but I never fully recovered from the initial thumb infection.

Every month or so I would be presented with what I think are the prodrome symptoms again and I would immediately start back on the Valtrex. I consistently have pain and weird feelings in that thumb, hand and arm, as well as throughout the rest of my body at times. I have been tested for everything under the sun from all STD’s to cancer and so on… I am at the end of my rope and I still have no concrete answers. I have never been diagnosed nor have had any breakouts of genital herpes to the best of my knowledge. I just saw my regular GYN today because for the past week I have been experiencing those “prodromes” symptoms again. headaches, pain in joints and muscles, aches in my thighs, buttocks and surrounding area, as well as thumb pain and aches in my hand and arm. Of course I started Valtrex again for 5 days and the symptoms started to subside. I didn’t take it on the 6th day, which was yesterday, and today the symptoms returned hence the reason I went to the doctor again.

She drew blood work and swabbed my vagina. She said that she didn’t see any signs of lesions ever existing. I was thinking that maybe I had genital herpes and that’s how I got the whitlow in the first place. I am again searching for some explanation for all of this I really hope you can advise. Thanks in advance for all your time; I know this is quite winded.
Confused and in need of Answers.

Dr. Rob’s Response:

Dear Confused and in need of Answers:

In all your evaluations, I do not see one indication that you were, in fact, tested for either varicella, which is chickenpox, which can result in shingles or Herpes Type 1 or Herpes Type 2. Without those tests, it’s impossible to state with certainty what was going on although many of your possibilities remain possibilities. 

If herpes is diagnosed, regardless of the type, it would be worthwhile considering under the auspices of your doctor, going on a suppressant regiment of Valtrex, 1 gram a day, to prevent these recurrent prodromes from occurring.

This is just a suggestion and one cannot diagnose over the internet, but it
would seem a reasonable course of action and might allay some of your concerns.


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