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Adult Still's disease presenting as serum sickness

A 30‐year‐old Chinese woman presented with fever of 104 °F, diffuse arthralgias, multiple pruritic erythematous papules and plaques, and pharyngitis. Three weeks prior to admission, she had received empirically a single intramuscuiar injection of penicillin for the pharyngitis. Several days later, fever, arthraigias, and an eruption were observed. The patient was started on oral prednisone, 40 mg daily, and tapered to 15 mg daily during a 21‐day period. The persistence of these findings led to subsequent hospitalization.