A 70-Year-Old Man With Fever and Polyarthralgia

Orlev, Amir; Miskin, Ian; Temper, Violeta; Korem, Maya

doi:10.1093/cid/cir620

Cited by 1 publication

(5 citation statements)

References 6 publications

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“…4,5 Streptobacillus moniliformis is an aerobic, gram-negative rod that requires microaerophilic culture conditions. 6 The organism can be obtained from blood, joint fluid, and cutaneous lesions. 4 Streptobacillus moniliformis is a colonizer of almost 100% of rodent airways and is transmitted to humans through a scratch or bite.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Transmission can also occur though exposure to excrement or saliva via food and water. 2,6 In these instances, the term Haverhill fever is favored over rat bite fever, in reference to a large outbreak from contaminated milk in Haverhill, Massachusetts. 7 Owing to the nonspecific symptoms, culture difficulty, and transmission in the absence of a rodent bite, rat bite fever is likely an underdiagnosed entity.…”

Section: Discussionmentioning

confidence: 99%

“…Streptobacillus moniliformis is an aerobic, gram-negative rod that requires microaerophilic culture conditions . The organism can be obtained from blood, joint fluid, and cutaneous lesions .…”

Section: Discussionmentioning

confidence: 99%

“…Streptobacillus moniliformis is a colonizer of almost 100% of rodent airways and is transmitted to humans through a scratch or bite. A bite holds a 10% risk of transmission and approximately 40 000 rat bites occur yearly in the United States . Transmission can also occur though exposure to excrement or saliva via food and water .…”

Section: Discussionmentioning

confidence: 99%

“…A bite holds a 10% risk of transmission and approximately 40 000 rat bites occur yearly in the United States . Transmission can also occur though exposure to excrement or saliva via food and water . In these instances, the term Haverhill fever is favored over rat bite fever, in reference to a large outbreak from contaminated milk in Haverhill, Massachusetts …”

Section: Discussionmentioning

confidence: 99%

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Petechiae, Purpura, and Hemorrhagic Vesicles

2017

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A man in his 70s was admitted to the hospital with encephalopathy, recent falls, leukocytosis, nausea, and arthralgias. On presentation to the emergency department, he received antibiotics owing to a concern for aspiration pneumonia. He underwent a stroke workup, including transesophageal echocardiography (TEE), results of which were negative. He was noted to have a progressing cutaneous eruption during his admission, and the dermatology department was consulted. He was found to have scattered petechiae and hemorrhagic vesicles, with most concentrated on the hands and feet (Figure , A and B). Palpable purpura were noted across the extremities. Several lesions were studded with pustules. He had an enlarging bulla on his left wrist. An abrasion on his left elbow was attributed to his recent falls. The infectious disease department was also consulted, and the patient was given broad-spectrum antibiotics owing to concern about endocarditis. As part of his dermatological workup, two 4-mm punch biopsy specimens were obtained (Figure, C and D). One was sent for histopathological examination, and the other was sent for fungal, bacterial, and mycobacterial cultures. A bacterial culture swab was obtained from the tense bulla on his left wrist.

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Section: Discussionmentioning

confidence: 99%