new_n_lost
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A man presents to a dermatologist because of a severe mucocutaneous rash that involves most of his body, including his palms and soles. Questioning reveals that he is a merchant marine who several months previously had an encounter with a prostitute in Southeast Asia.
Which of the following is the most likely causative agent of this rash?
A. Herpes simplex I
B. Herpes simplex II
C. HIV
D. Neisseria gonorrhoeae
E. Treponema pallidum
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| SILVER
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E. Treponema pallidum
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| GoodGirl
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E, treponema
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| unique1
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E .... 
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| drhouse
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Rash distribution looks like syphilis.. .....
but can v stamp diagnosis only on the base of rash distribution and little bit of history.
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| Novak75
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E....
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| Novak75
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love your avatar drhouse... ....I have a crush on dr. house..jajajaja
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| new_n_lost
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The correct answer is E.
Edited by new_n_lost on 07/14/07 - 10:09 PM
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| new_n_lost
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The correct answer is E.
The rash described is that of secondary syphilis, caused by Treponema pallidum. Involvement of palms and soles by a rash is unusual, and secondary syphilis should come to mind. Not all patients with secondary syphilis have a severe form of the rash, and consequentially some cases are missed. Primary syphilis takes the form of a painless, button-like mass called chancres. Tertiary syphilis, which is now rare, has a propensity for involving the aorta and central nervous system and can also cause "gummas" (granulomatous-like lesions) in many sites, notably including liver and bone.
Herpes simplex I (choice A) usually causes perioral vesicular lesions.
Herpes simplex II (choice B) usually causes genital vesicular lesions.
HIV (choice C) does not itself cause a rash, although co-infection with other organisms can result in
a rash.
Neisseria gonorrhoeae (choice D) does not typically cause a rash.
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| drhouse
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thanks Novak,
i like drhouse too..
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| Ig F
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Secondary Syphilis appears 1-3 months after the exposure to the organism.....maculopapular rash involving alost all partz of the body including palms and soles,mucous membranes and sometimes cause alopecia as well...may heal spontaneously,or regress several times before healing..........
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