The patient is a 56-year-old man who has been ill for 10 days with fevers, rigors, sweats, and migratory arthralgia’s that became a monoarticular arthritis of the knee. Past medical history Medical history: schizophrenia, hypertension, type 2 diabetes Medications: none currently; has taken antipsychotics in the past Allergies: none Habits (polysubstance use): heroin, methamphetamine, and cocaine; all intermittent, on the basis of finances and availability. Smokes tobacco and drinks alcohol.
Pets: owns several pet rats (wild rats he catches and cages). One rat bit him 2 weeks ago. Diet: regular Social: sexually active with both men and women Immunizations: up to date Sports/water exposure: none Infectious disease exposure: none Physical examination Vital signs: temperature, 102° F; pulse, 80 beats/min; respiratory rate, 14 breaths/min; blood pressure, 130/85 mm Hg General: ill-appearing…
