Alexis is a 43-year-old teacher who presents with 10 days of daily high-grade spiking fever (39°C), with associated polyarthralgia, sore throat and itchy rash on the chest and back.

Test your clinical know-how by taking the quiz below. If you select the wrong answer, have another go — you can try as many times as you like!

<p>Alexis is a 43-year-old teacher who presents with 10 days of daily high-grade spiking fever (39°C), with associated polyarthralgia, sore throat and itchy rash on the chest and back (pictured).</p><p>There are no associated gastrointestinal symptoms, and Alexis denies recent mushroom consumption or open-water swimming.</p><p>She has no past history of note and takes paracetamol only for fever and pain.</p><p>On examination, she is febrile, tachycardic and mildly hypotensive.</p><p>The rash appears as multiple red-to-brown linear plaques resembling whip marks on the torso. The face and shoulders are spared.</p><p>Alexis is referred to ED, where pathology reveals a leucocytosis with neutrophilia and markedly increased ESR, CRP and ferritin.</p><p>Blood and urine cultures are negative, as are viral serologies (CMV, Epstein–Barr virus, hepatitis A/B/C).</p><p>Autoimmune antibodies (antinuclear antibody, rheumatoid factor, anti-cyclic citrullinated peptide, anti-Ro, anti-La and anti-double-stranded DNA) are negative.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.