A 20-year-old woman in Dallas, Tex., rushed to the hospital after waking one morning with a bumpy rash on her hands, arms, legs, scalp and torso. She was later informed the unusual skin lesions were caused by a sexually transmitted disease (STD).

The woman, whose case was documented last week in The New England Journal of Medicine, arrived at the University of Texas Southwestern Medical Center in Dallas with muscle aches, fever and pain in both of her ankles in addition to the rash.

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After a series of tests, the woman, who has not been identified publically, was diagnosed with gonorrhea — an STD that most commonly affects those aged 15 to 24, per the Centers for Disease Control and Prevention (CDC). The woman reportedly told doctors she had unprotected sex with a new partner a couple of weeks before experiencing symptoms.

“There was mild swelling and pain with passive motion in the right ankle and tenosynovitis involving the tendons of both ankles,” doctors wrote in the case review, noting there was “high suspicion for disseminated gonococcal infection” before tests officially confirmed that was the case.

Gonorrhea — colloquially referred to as “the clap” — is an STD that can affect both men and women, typically causing “infections in the genitals, rectum and throat,” the CDC says. Most people become infected with gonorrhea after having intercourse with someone who has the disease.

Men who have the STD can experience a burning sensation when urinating, discharge from the penis (it’s usually green, yellow or white in color) and swollen testicles. For women, however, symptoms are less obvious — if they’re apparent at all.

“Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection,” the federal health agency says, noting women with gonorrhea “are at risk of developing serious complications from the infection, even if they don’t have any symptoms.”

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If a woman does experience symptoms, however, they typically include a burning sensation when peeing, increased vaginal discharge and bleeding between periods, among other signs.

The disease can cause serious complications if left untreated. The gonorrhea bacterium is capable of spreading through an untreated person’s bloodstream and eventually infecting other parts of their body, causing joint pain and a skin rash, much like the woman experienced, according to the Mayo Clinic. If the disease is left untreated altogether, it can also lead to infertility in both men and women.

As for the Texas woman, she was prescribed antibiotics to rid her of the infection. Three months later, she was “feeling well, with no recurrence of skin lesions or joint pain,” the doctors said.