Doctors thought it was a simple foot infection. They were so wrong.
A 41-year-old management analyst, Melissa Bogner had grown accustomed to periodic bouts of neuropathy - numbness in her hands and feet - the apparent legacy of a severe allergic reaction to a drug she took in 2000 to treat a gynecological infection. But this 2015 episode was different. Along with the sensation that her feet felt unusually warm, the skin on the second toe of her right foot looked inflamed. Weeks later, she noticed a small blister. Bogner initially ignored it thinking whatever was wrong would go away on its own. It looked like a fungal infection and she tried an over-the-counter remedy but discovered that the ointment irritated her toe. Instead of clearing up, there were signs that the redness was spreading to her third toe. Sometimes her toe would itch and feel tingly. By the end of May, her toes were still inflamed and her feet felt so hot that she routinely removed her shoes while she was sitting down. The problem seemed to be affecting her left foot as well. The sensation of heat and the tingling were undiminished. At other times, the redness seemed to lessen, but it never disappeared entirely.
Clue 1: Changing footwear didn’t help
Clue 2: A potent cream containing a corticosteroid exacerbated the problem
Clue 3: Bogner did not have diabetes
Clue 4: Testing by the cardiologist found nothing to account for the skin discolouration or tingling, such as peripheral artery disease
Clue 5: Blood tests ruled out cancer, Lyme disease, various auto immune or bone-marrow problems, and a genetic mutation
Clue 6: She was tested for small fiber neuropathy, but it was not the cause