What is the diagnosis for a female patient presenting with severe whole body pain, fever, and paresthesia (abnormal sensations) of the lower extremities?

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Differential Diagnosis for Female Presenting with Extreme Whole Body Pain, Fever, and Paresthesia of Lower Extremities

  • Single most likely diagnosis
    • Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, and tender points, which could explain the extreme whole body pain. However, the presence of fever and paresthesia might suggest other underlying conditions that need to be ruled out.
  • Other Likely diagnoses
    • Multiple Sclerosis (MS): MS can cause widespread pain, fever, and paresthesia due to demyelination of nerve fibers. The paresthesia in the lower extremities could be indicative of MS, especially if there are other neurological symptoms.
    • Rheumatoid Arthritis (RA): RA is an autoimmune disorder that can cause whole body pain, fever, and sometimes neurological symptoms like paresthesia, especially if there is associated neuropathy.
    • Lupus: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can cause a wide range of symptoms including whole body pain, fever, and neurological symptoms like paresthesia.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Guillain-Barré Syndrome: This is a rare autoimmune disorder where the body's immune system mistakenly attacks part of its peripheral nervous system, which could lead to widespread pain, fever, and ascending paresthesia or paralysis. It's critical to diagnose early due to the potential for rapid progression to respiratory failure.
    • Spinal Cord Compression or Abscess: Conditions affecting the spinal cord can cause severe pain, fever, and neurological deficits including paresthesia. Early diagnosis is crucial to prevent permanent neurological damage.
    • Sepsis: Although less directly related to paresthesia, sepsis can cause widespread pain and fever. In severe cases, sepsis can lead to organ failure and death, making early recognition and treatment critical.
  • Rare diagnoses
    • Sjögren's Syndrome: An autoimmune disorder that can cause widespread pain, fever, and sometimes neurological symptoms, though it's more commonly associated with dry eyes and mouth.
    • Mixed Connective Tissue Disease: A condition that combines features of lupus, scleroderma, and rheumatoid arthritis, which could explain the wide range of symptoms.
    • Neuropathic conditions like Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): CIDP can cause progressive weakness and sensory loss, which might include paresthesia, but it's less common than other diagnoses listed here.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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