https://orcid.org/0009-0008-3894-5153
-
Views
-
Cite
Cite
Angelica Chan, Nicholas Kensey, Houda Abdelrahman, Sophie Tesson, James Higgs, A 34-Year-Old Man With a Pustular Rash, Subjective Fever, and Foot Pain, Clinical Infectious Diseases, Volume 80, Issue 3, 15 March 2025, Pages 657–659, https://doi.org/10.1093/cid/ciae509
Close - Share Icon Share
Extract
QUESTION
A 34-year-old man without significant past medical history presented to a New England hospital with 1 week of left foot pain, myalgias, subjective fever, and rash. The rash was nonpruritic, nontender, with pustular eruptions most pronounced over the extremities (including the palms and soles) with sparing of the chest, face, and back (Figure 1). Three days prior to presentation he developed left wrist pain and left foot erythema, swelling, and pain, which limited his ability to walk. He had a history of incarceration 6 years prior and denied any history of intravenous drug use. He was last sexually active 2 years prior with 1 female partner. He cared for a large variety of animals at home including ferrets, rats, rabbits, pigs, cats, hamsters, a mole, goldfish, and turtles. One week prior to the current presentation, he recalled being bitten on the hand by one of the rats.
...
On arrival, he was afebrile with laboratory evaluation notable for a white blood cell count of 9.2 × 103/μL with normal differential, platelets of 185 × 103/μL, and renal and liver chemistries within reference limits. Fourth-generation human immunodeficiency virus testing was negative. Blood cultures showed no growth after 5 days. Several pustules from the left hand were unroofed and sent for gram stain and culture (Figure 2).
