Infectious Disease
Case 17: A Patient with Fever and Joint Pain
CASE
A 34‐year‐old banker presented to his GP with a 5‐day history of fever and joint pain. He is currently single but has had unprotected sexual intercourse with two female partners in the last 6 months. He recalls having a slight urethral discharge about 1 month ago but this was self‐limiting so he did not pursue it. On examination he had a low‐grade fever and a hot right knee effusion and a pustular rash surrounds the joint. He has previously been well.
The following results were available to you:
Haematology profile Normal Biochemical profile Normal Glucose Normal CRP 240 mg/L Rheumatoid factor Negative Autoantibody screen Negative HIV Negative Hepatitis screen Negative
Joint aspirate: turbid fluid, no organisms, no crystals
QUESTION 1
Your score this session: 0 of 0
What investigation would you next initiate?