Case: A man with fever, malaise, and rash

A 36-year-old man presents with complaints of fever, malaise, and rash. He returned from vacation to Bangkok 3 weeks ago.

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On physical examination you see a moderately ill man with a temperature of 38.4°C. There are enlarged, firm, elastic lymph nodes on both sides of the neck up to 1.5 cm in size. Upon examination of the oral cavity, removable white deposits will be noted (Figure 1). There are scattered, faint red spots on the skin of the trunk (Figure 2).

Figure 1 Figure 2

What is surprising is the redness of the palms of the hands and the soles of the feet (Figures 3 and 4).

Figure 3 Figure 4

What is your diagnosis?

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