Article: Increasingly red and painful lesion coupled with joint pain and fever: over the course of 10 days in September, a sore on the patient's ankle grew in size, and he developed a petechial rash.(CASE)

Mr. M was 53 years old and lived in rural South Carolina. He complained of a skin lesion that had first appeared on his left ankle 10 days earlier (around the middle of September). Since then the center of the sore had become dark, and Mr. M noted generalized joint pain. Over the past four or five days, the lesion had become increasingly red and painful. He reported no headache or rash.

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The patient's past medical history was significant for osteoarthritis, allergic rhinitis, tension and migraine headaches, hypertension, hypercholesterolemia, and inguinal hernia repair. His current medication regimen included fexofenadine (Allegra) ...

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