A 56-year-old man presented with fever, sweat, rigors, and monoarticular arthritis for ten days after one of his pet rats bit him two weeks ago. His medical history included schizophrenia, type 2 diabetes, and hypertension. He was not on any medication at present, though he used to take anti-psychotic drugs before.
He did not have any allergies but was a regular smoker. He also consumed alcohol regularly and intermittently took drugs like heroin, cocaine, and methamphetamine. Physical examination Temperature: 102° F Pulse: 80 beats/min Respiratory rate: 14 breaths/min Blood pressure: 130/85 mm Hg He appeared ill with wheezing in his lunges and grade 3/6 murmur Mild splenomegaly Erythematous and edematous knee which was warm to touch, no emboli Rat bite was healed Laboratory results WBC: 15,000 cells/µL Hb: 12 g/dL Aminotransferase: twice normal Urine analysis: 10-20 RBCs Bilirubin:…
