combat medic in iraq

I have an 18 y/o female patient who had her wisdom teeth removed about 2 to 3 weeks ago she is now presenting with severe joint pain and jaw pains joint pains presents like RA what else could it be?

My thoughts:

Its possible that she could have rheumatic fever. As I’m sure you are aware, streptococcus can get released in to the blood causing a bacteraemia. One of the consequences of this is inflammatory problems in the joints and heart. It can cause fever and a skin rash called erythema marginatum. Treatment is with high dose penicillin. Endocarditis with this condition can cause long-term heart valve problems.

Another possibility is Lemierres syndrome where tracking of infection can occur down the post pharyngeal space, although this usually causes abscesses. Finally, it could just be a reactive arthropathy which is normally treated with NSAID’s and simple analgesia. This usually settles in time.




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