8th July 2024

A 46-year-old lady presents with a fever, fatigue, joint pain and a maculopapular rash on her face

A 46-year-old lady presents with a fever, fatigue, joint pain and a maculopapular rash on her face and trunk. She was treated with amoxicillin for 2 weeks by her GP for a suspected chest infection.

Investigations show: Hb 140 g/L (115-165), WBC 13.6×10⁹/L (4-11), Neutrophils 7.9×10⁹/L (2-8), Eosinophils 1.2×10⁹/L (0.1-0.4), Platelets 185×10⁹/L (150-400), Na 137 mmol/L (135-145), K 4.7 mmol/L (3.5-5), Urea 8.6mmol/L (2.5-7.5), Creatinine 185 μmol/L (60-110). Urine dipstick showed 2+ protein, 1+ Blood.

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