A case of persistant hectic fever

Mr GH was a 59 year old factory worker from Cape Town. He presented to GSH with a 2 week history of fever, rigors, weakness and a fine maculopapular rash. He was also noted to have an ulcerating papule on his left forearm.  He had previously been well and there was no past medical history of note. He also gave no history of recent travel outside of Cape Town. He had not been walking in the veld and did not have any pets.