Case Report
A thirty-eight year-old male presented to the outpatient primary care
clinic with a seven-week history of fever unresponsive to oral
antipyretics. The patient also noted recurrent chills, night sweats,
myalgias, headaches, and chest tightness. Three days before
presentation, he developed a cough with clear sputum. A complete review
of systems was otherwise negative. A careful history emphasizing
surgical, social, and travel components revealed that the patient had
undergone arthroscopic ACL reconstruction seven weeks prior to
presentation, after which his fever began. He tested negative for
COVID-19 pre-operatively. On surgical follow-up, his orthopedist found
no surgical or thromboembolic complications or other iatrogenic cause
for fever. Approximately one week after initial presentation, the
patient developed an erythematous maculopapular rash on the palmar
surfaces of both hands (Figure 1 ). Arthralgias, myalgias, and
morning stiffness worsened, and the rash spread over his torso.