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Images in paediatrics
Rat-bite fever in a child without a bite
  1. Nelson Yu Wang1,
  2. Joshua Osowicki1,2
  1. 1 Department of Infection and Immunity, Monash Children's Hospital, Clayton, Victoria, Australia
  2. 2 Infectious Diseases unit, Department of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Dr Nelson Yu Wang, Department of Infection and Immunity, Monash Children's Hospital, Clayton, VIC 3168, Australia; nywan3{at}

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A previously well, fully immunised 8-year-old boy was admitted to a tertiary paediatric hospital with a 5-day history of fever, papular rash and migratory arthralgia affecting his left wrist, right shoulder and both ankles. By day 6 of the illness, a petechial rash with scattered flat grey vesicles was apparent on the hands and feet, including palms and soles, without mucosal involvement (figure 1). On initial blood tests, he had …

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  • Contributors NW and JO conceived of the presented idea. NW completed the investigation and writing of the manuscript draft. NW and JO reviewed and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.