A 32-year-old heterosexual male presents to the physician with a 3-day history of multiple skin lesions located all over his body and on his mucous membranes.He hasn't felt well and has a low-grade fever.The patient cuts down trees in Massachusetts for a living.He is single,has had multiple sex partners,and does not use condoms.Here are the results of his laboratory tests: rapid plasma reagin = reactive 1:128; Treponema pallidum-particle agglutination assay = reactive; Borrelia burgdorferi IgM =

Question

A 32-year-old heterosexual male presents to the physician with a 3-day history of multiple skin lesions located all over his body and on his mucous membranes.He hasn't felt well and has a low-grade fever.The patient cuts down trees in Massachusetts for a living.He is single,has had multiple sex partners,and does not use condoms.Here are the results of his laboratory tests: rapid plasma reagin = reactive 1:128; Treponema pallidum-particle agglutination assay = reactive; Borrelia burgdorferi IgM = < 1:8; Rickettsia rickettsii IgM < 1:8.This patient has:

Quizplus · Accepted Answer

The patient's history of multiple sexual partners and lack of condom use, along with his positive rapid plasma reagin and Treponema pallidum-particle agglutination assay, suggest that he has secondary syphilis. The presence of multiple skin lesions and mucous membrane involvement also supports this diagnosis. The negative results for Borrelia burgdorferi IgM and Rickettsia rickettsii IgM make Lyme disease and Rocky Mountain spotted fever less likely.

A 32-Year-Old Heterosexual Male Presents to the Physician with a 3-Day