A 19-year-old woman has presented to the emergency department complaining of fever and malaise after returning from a holiday. Over the preceding 3–4 days, she noticed a rash and sore throat and is now feeling tired and unwell. She admits to several episodes of unprotected sexual intercourse during the holiday. Past medical history : None Examination The woman is febrile and tachycardic.
Her heart sounds are normal, her chest clear and her abdomen soft and non-tender. She has widespread lymphadenopathy; the lymph nodes are 2 cm in diameter and are soft and tender on palpation. There is an erythematous, maculopapular rash covering her trunk. Observations Temperature : 37.8°C HR : 98/min BP : 110/88 mmHg RR : 16/min S aO 2 99% on room air WCC : 14.0 x 10 9 /L Hb : 15.0 g/dL Platelets : 100 x 10 9 /L Sodium : 133 mmol/L Potassium : 3.7 mmol/L Urea : 4.5 mmol/L Creatinine : 77 μmol/L…
