REPORT OF A CASE
A 66-year-old white woman was transferred to our hospital with a history of recurrent fever and rash. She was well until 10 days before admission, when she first experienced an episode of nocturnal chills, rigors, and fever accompanied by diffuse severe headache. These symptoms had resolved by morning, when she awoke to find a rash on her arms and legs composed of discrete erythematous spots that faded over the next 2 to 3 days. She had two similar episodes in the week before admission and, on the last occasion, also noted erythema, swelling, and tenderness of her right metatarsophalangeal joint.At admission, the physical examination showed unremarkable findings except for a temperature of 38°C. Lymphadenopathy, organomegaly, or cardiac murmur was not present. She did have moderately inflamed soft tissue in the area of the right metatarsophalangeal joint with evidence of an effusion in the joint cavity.
Gregory B, Tron V, Ho VC. Cyclic Fever and Rash in a 66-Year-Old Woman. Arch Dermatol. 1992;128(12):1643-1648. doi:10.1001/archderm.1992.04530010149016