CASE HISTORY Odonna,a Pregnant 18-Year-Old Woman,came to the Nassau County,New York,urgent-Care Clinic

question 33

Essay

CASE HISTORY
Odonna,a pregnant 18-year-old woman,came to the Nassau County,New York,urgent-care clinic with a low-grade fever,malaise,and headache.She was sent home with a diagnosis of influenza.She again sought treatment seven days later after she discovered a macular rash (flat,red)developing on her trunk,arms,palms of her hands,and soles of her feet.She thought maybe she was allergic to the new soap she was using,but the rash was not itchy or painful.Further questioning of the patient revealed that one year ago she had a painless ulcer on her vagina that healed spontaneously.She was diagnosed with secondary syphilis,a stage of the disease that can mimic many other conditions.She was given a single intramuscular injection of penicillin and told that her sexual partners had to be treated as well.
If Odonna's infection had not been correctly diagnosed at this stage,how might the disease have progressed,and what complications would she be likely to face? Would these be different if the patient were male?

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