ID Fellows Cup Question 26

<23-year-old man presents to the clinic with a rash in his left foot. He is originally from the highlands of Peru and had spent the previous 2 months visiting some family there. They went hiking and rafting multiple times. Although his home had well water, he states he only drank bottled water during his trip. He has no medical problems. He is not sexually active and does not use intravenous drugs. He denies current fevers, chills, or night sweats. The rash is pictured

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