Occupational injury in a fishmonger with a macular rash, hepatosplenomegaly and pancytopenia.
A 47-year-old fishmonger presented with a history of weight loss and lethargy. On investigation he was found to have myeloma. He presented again before follow up, with a 3-day history of fever and a maculopapular rash. He was admitted to the haematology ward and treated with broad-spectrum antibiotics. Blood cultures were found to be positive for Erysipelothrix rhusiopathiae. Penicillin treatment was given, and he made a good recovery. The importance of occupational illness in an already immunocompromised patient and of taking a proper social and occupational history from patients on admission is illustrated through this case.
Cooke
L J
LJ
Department of Haematology, Addenbrooke's Hospital, Cambridge, UK. lisajc@doctors.org.uk
Bowles
K M
KM
Craig
J I O
JI
Sule
O
O
D004889:Erysipelothrix Infections / Q000150:complications / Q000175:diagnosis*; D005511:Food Handling; D006529:Hepatomegaly / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications; D009784:Occupational Diseases / Q000175:diagnosis* / Q000382:microbiology; D010198:Pancytopenia / Q000382:microbiology; D017747:Seafood / Q000382:microbiology*; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000382:microbiology; D013163:Splenomegaly / Q000382:microbiology