Image of the Week: Headache and a rash on the trunk and extremities

A 32-year-old woman presents with a headache and a rash on her trunk and extremities. She has had unprotected sex with multiple partners during the last 2 months but denies any history of sexually transmitted infections. Examination reveals generalized nontender lymphadenopathy, a diffuse macular rash on her chest and arms, and patchy hair loss. Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody-absorption (FTA-ABS) tests are both positive, and she is given a single dose of penicillin G benzathine intramuscularly. She returns within a few hours with a worsening rash (seen here), myalgia, and a fever. Which of the following is the next best step in managing this patient’s reaction? Learn more about this case, take the quiz, and join the conversation on Figure 1.

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