history of intermittent diarrhea, urethral discharge, and pain in the left knee
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A 23-year-old man has a 2 week history of intermittent diarrhea, urethral discharge, and pain in the left knee. He is sexually active with multiple partners. He has several oral ulcers, iritis, a scaly papular rash on palms and soles. Genito urinary examination shows multiple superficial ulcers on the glans penis. The results of gram-stain and culture of urethral discharge are negative. Rheumatoid factor is not present.
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