A patient complains of recent onset of aching and malaise followed by the development of a generalized rash. He denies previous rash, although he does admit that about a month ago he had an open sore on his right hand that was nonpainful. The examination reveals a maculopapular rash and lymphadenopathy. This presentation is most consistent with:

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The patient's symptoms of a generalized rash, lymphadenopathy, and a history of a nonpainful open sore (chancre) on the hand about a month ago are consistent with secondary syphilis. Secondary syphilis can present with systemic symptoms such as malaise and a characteristic rash, often following the initial chancre by several weeks.

A Patient Complains of Recent Onset of Aching and Malaise