Symptoms After Toenail Injury: Fever, Dizziness, and More

After injuring the toenail, a series of symptoms began, primarily persistent low-grade fever and dizziness?

Hello, Doctor.
At the beginning of last month, while on a business trip and staying at a hotel, I accidentally injured my right big toe by pinching it in the door.
There was a crack about one-third of the way up the nail, and within five minutes, there was bleeding under one-third of the nail.
Two hours later, I went to a nearby clinic for debridement and dressing.
The next evening, I started experiencing the first and second symptoms: intermittent pain in the back of my neck and wandering pain in both hands.
The toe injury healed quite well, and I removed the dressing on the third day; there was no redness or swelling, and I could walk normally.
However, that night, I began to develop a low-grade fever, and the wandering pain in my hands intensified.
On the fourth day, all symptoms worsened significantly: I had a severe headache, felt weak, started to feel cold, and was reluctant to turn on the air conditioning.
My muscles and joints began to ache, sometimes intermittently and sometimes continuously.
On the sixth day, after returning home, I had blood tests done, which showed slightly elevated white blood cell counts.
The doctor said it was a common bacterial infection and prescribed some antibiotics, but they didn’t seem to help with the low-grade fever.
This continued until the fifteenth day when I started feeling dizzy (not the same as the headache).
Sometimes the dizziness made me want to close my eyes and rest, but I didn’t feel faint while walking.
The previous symptoms were still present.
On the fifteenth and nineteenth days, I had blood cultures and some basic rheumatological and immunological blood tests, all of which came back normal.
My white blood cell count returned to normal levels.
On the twenty-seventh day, I sought help from a traditional Chinese medicine practitioner, as the dizziness was far more bothersome than the low-grade fever at that time.
They prescribed a formula primarily for treating dizziness and an auxiliary treatment for the low-grade fever.
I took it for a total of seven days, with noticeable effects in the first five days.
On the sixth day, the low-grade fever returned, and after finishing the seven-day formula, I experienced dizziness again the following day.
The low-grade fever and dizziness generally start in the afternoon and continue until bedtime, with the fever being between 37.2°C and 37.7°C.
Recently, I seem to have developed acute urticaria on both arms; when I feel itchy and scratch a little, a white bump appears.
I would like to ask you if these symptoms are related to my toe injury (which was one month and seven days ago today) since they all appeared after the injury.
What other tests can I do to find the cause? I hope there isn’t anything serious.
Thank you for your time!

Xiao Xin, 20~29 year old female. Ask Date: 2021/08/09

Dr. Lin Wufu reply Internal Medicine

Hello! Generally, a nail injury is unlikely to cause a systemic infection (unless the local wound condition is very poor).
Your initial symptoms resemble those of a systemic inflammatory response or infection, but typical infections do not usually last for a month.
It would be advisable to investigate rheumatological and immunological aspects, or consider some chronic infections.
I recommend visiting an infectious disease clinic for further evaluation.

Reply Date: 2021/08/09

More Info

In your case, the symptoms you are experiencing following your toenail injury are indeed concerning and warrant further investigation. The timeline of events you described—starting with the injury to your big toe, followed by fever, dizziness, and other systemic symptoms—suggests that there may be more than just a localized issue at play.

Initially, the injury to your toenail, which resulted in bleeding and a crack in the nail, could have introduced bacteria into the tissue beneath the nail. While you mentioned that the injury was treated and that there was no redness or swelling, it is still possible for an infection to develop internally, leading to systemic symptoms such as fever and malaise. The fact that you experienced a low-grade fever (37.2-37.7°C) and elevated white blood cell count indicates that your body was responding to some form of infection or inflammation.

The progression of your symptoms, including neck pain, muscle aches, and joint pain, suggests that your body may be dealing with a more widespread inflammatory response. This could be due to a localized infection that has spread or a reaction to the injury itself. The presence of dizziness and the acute urticaria (hives) you mentioned could also indicate an allergic reaction or a systemic inflammatory response, which can sometimes occur after an injury.

Given that your blood tests, including cultures and autoimmune panels, returned normal results, it is essential to consider other potential causes for your symptoms. Chronic infections, such as osteomyelitis (an infection of the bone) or septic arthritis, could be possibilities, especially if the infection was not adequately addressed initially. Additionally, conditions like reflex sympathetic dystrophy (RSD) could lead to persistent pain and other symptoms following an injury.

To further investigate the underlying cause of your symptoms, I recommend the following steps:
1. Imaging Studies: An X-ray or MRI of the affected toe and surrounding areas could help identify any underlying bone or joint issues, such as fractures or signs of infection.

2. Infectious Disease Consultation: If you suspect a chronic infection, consulting with an infectious disease specialist may provide insights into further testing or treatment options.

3. Allergy Testing: Since you mentioned the appearance of hives, it may be worthwhile to explore potential allergic reactions to medications or other environmental factors.

4. Neurological Evaluation: Given your dizziness and other neurological symptoms, a consultation with a neurologist may be beneficial to rule out any neurological complications.

5. Physical Therapy: Engaging in physical therapy may help address any functional limitations and provide strategies for managing pain and improving mobility.

In conclusion, while your symptoms may have started with a toenail injury, the subsequent systemic reactions indicate that further evaluation is necessary to rule out more serious conditions. It is crucial to stay vigilant and seek medical attention promptly, especially if your symptoms worsen or new symptoms arise. Your health and well-being should always be the priority, and addressing these concerns with your healthcare provider will help ensure you receive the appropriate care.

Similar Q&A

Sudden Toe Pain: What Could Be Causing Your Symptoms?

Last night, the tip of the second toe on the left side of my right foot suddenly felt like it was being shocked, causing me to fall back into my chair. It was only one toe, with no visible wounds and intact skin. Upon closer inspection, there were no puncture marks. The pain star...

Dr. Jiang Junyi reply Neurology
Hello, based on your description, it may be necessary to consider neuropathic pain. Its manifestations differ from typical pain following tissue injury, including sensations such as tingling, stabbing, electric shock, tearing, burning, coldness, numbness, and itching, often accom...

Post-Surgery Wound Care: Managing Complications After Orthopedic Procedures

Hello, Recently, I was involved in a car accident that resulted in intracranial hemorrhage, a skull base fracture, head trauma, an open fracture of the first metatarsal in my right foot, and lacerations on both sides of my right heel that required suturing. I spent seven days i...

Dr. Wang Shouji reply Orthopedics
Hello, if there are abnormalities in the wound accompanied by fever, it is advised to return for a follow-up appointment immediately. If there are no outpatient services available, please go to the emergency department to confirm whether the issue is related to the wound or cause...

Understanding Post-Concussion Symptoms: Tremors, Dizziness, and Pain

Hello Doctor: Since the night of the car accident on January 6th, I have experienced sudden jerking movements in my left hand and foot shortly after falling asleep. I wake up and continue to sleep, but the jerking still occurs, though not frequently—about 2 to 3 times. Recently, ...

Dr. Jiang Junyi reply Neurology
Dear Miss Rabbit, You mentioned that "since the night of the car accident on January 6th, my right eye has been blurry, and my left hand and foot have been experiencing spasms... I have never had these symptoms before." Your symptoms may warrant consideration of lesion...

Understanding Pain After Nail Removal: What to Expect and When to Worry

Hello, I had a quarter of my nail and nail bed removed a week ago. I still experience pain when touching the nail or my big toe, and I cannot wear shoes. Moving my toe also causes pain, and I occasionally feel sharp pains, but there is no discharge from the wound. Is this normal?...

Dr. Xu Kaixi reply Surgery
After the removal of a fingernail (or toenail), the wound typically forms a scab in about a week. At this point, the discharge should have decreased or ceased, and some pain at the site is normal. However, if there is unusual pain accompanied by redness, swelling, and increased d...