A 28-year-old woman was admitted to the acute medical unit. She was 34 weeks pregnant, and presented with a four-week history of sore throat, evanescent rash, night sweats, flitting joint pain and stiffness, and fevers of up to 40.0°C, which tended to occur in the early evening. The rash was noted to worsen when her temperature was elevated.
On examination, she had bilateral submandibular and inguinal lymphadenopathy, a quiet pericardial rub, mild splenomegaly, a vague macular rash over the trunk with Koebner’s phenomenon, and painful knee and wrist movements, but no synovitis or joint effusions. In the week after admission, her symptoms continued with no change.
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