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Occupational injury in a fishmonger with a macular rash, hepatosplenomegaly and pancytopenia
  1. L J Cooke,
  2. K M Bowles,
  3. J I O Craig,
  4. O Sule
  1. Department of Haematology, Addenbrooke’s Hospital, Cambridge, UK
  1. Correspondence to:
    L J Cooke
    Department of Transfusion Medicine, National Blood Service, Long Road, Cambridge CB2 2PT, UK; lisajc{at}


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.

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  • Competing interests: None declared.

  • Informed consent was obtained for the publication of the patient’s details in this report.