A 30-year-old woman is brought to the emergency department for a one-day history of diffuse muscle and bone pain, vomiting, rash, and fever. Vitals are: temperature 102 F, HR 105, RR 18, BP 80/55. Physical examination shows a diffuse maculopapular rash on the face, trunk, hands, and feet. There is 1+ bilateral peripheral edema. She works as a horticulturalist. Which of the following is the most likely explanation for these findings?
Arsenic poisoning
Rocky Mountain spotted fever
Secondary syphilis
Toxic shock syndrome
Waterhouse-Friderichsen syndrome
