History: A patient is a 56-year-old man who has been ill for 10 days with fever, rigors, sweats, and migratory arthralgias that further developed into monoarticular arthritis of the knee. The patient had a history of schizophrenia, hypertension, type 2 diabetes and had taken antipsychotics in the past. The patient was an addict of heroin, methamphetamine cocaine, tobacco, and alcohol.
The patient had a rat bite 2 weeks ago prior to presentation. 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 HEENT: poor dentition Lungs: wheezes Heart: grade 3/6 murmur Abdomen: possible mild splenomegaly Extremities/skin: no emboli; erythematous, edematous knee, warm to touch Skin: healed rat bite Neuro: normal Diagnostic Evaluation: . The following values were obtained: WBC count: 15,000…
