Brief Answer: She needs to be evaluated to identify the cause.. Detailed Answer: Hi, Since her doctors are considering infective causes, I assume that the cramps started recently. If she is not running fever and other tests ruled out infection, I am slightly concerned and would like to investigate her further to isolate the cause. A few tests that I would like to perform are: 1. Check her blood circulation. Both arterial circulation impairment as well as clots in vein would cause severe leg cramps. I hope her doctors have examined her peripheral blood vessels and ruled out impaired blood circulation. I would order for Doppler studies if there is minimal suspicion about impaired circulation. 2. Muscle inflammation (myositis) secondary to autoimmune reasons. I see her doctors working on it. 3. Electrolyte and metabolic abnormalities include thyroid disorder. I would order serum electrolytes, blood sugar, thyroid functions and renal functions. 4. If she is on water pills (diuretics) to control her blood pressure, this may be drug induced. 5. Pregnancy status needs to be excluded if your daughter has missed periods. Rarely these pain may be a referred pain from the back. Though this seems least likely I would consider a neurological examination if she also has significant clinical signs. Her treating doctor can help you. In short, the symptoms look concerning. I hope her doctors find the right cause soon. Investigations is going to be the key here. In the interim I would encourage her to keep drinking plenty of fluids. Let me know if you need clarifications. Regards

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