MRCP2-2656
A 30-year-old female returned from Tanzania 2 weeks ago and presents to the medical take with symptoms of fever, headache and generalised arthralgia. She had taken doxycycline as an antimalarial and had been fully vaccinated prior to her travel. However, she admits to getting mosquito bites regularly whilst away and had a severe reaction to one of them, leaving a mark on her shoulder. On examination, she appears drowsy, has mild hepatosplenomegaly and a well circumscribed, rubbery, painful, red lesion approximately 5 cm in diameter above her left shoulder. What is the likely diagnosis?