17 yr old female with history of multiple sexual partners and a therapeutic abortion at 14 yrs old presented with fever, rash generalized fatigue, and acute pain in the left eye. In the last 2 months she has lost 12 kg in weight and reports an intermittent fever with fatigue of the same duration. upon physical exam, She appears ill, has marked conjunctival infection, a tender sclera with palpation, and left retinal detachment with some periorbital swelling. Other physical examination is unremarkable, although she does have prominent nontender cervical nodes. There is also swelling of the inguinal nodes, a macular rash (small, flat spots) on the thigh, and a faint cardiac murmur in the upper chest. . HIV tests were negative, but a serologic test for syphilis was positive, although a hemagglutination test for Treponema pallidum was negative. Urine showed 2+ protein, some red blood cells, and some hyaline casts. Blood screen shows hemoglobin at 80%, with a lymphocyte count of 20% of normal and low platelets. The chest radiograph was normal.