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These bacteria are an important cause of disease in swine. Humans acquire occupational skin infections called "fish handler's disease," "whale finger," and "seal finger." Other workers affected include those handling infected tissues of turkeys, or rarely, chickens, sheep, or cattle. The typical skin lesion is purplish-red and indurated. There may be a hemorrhagic vesicle but suppuration is unusual. Systemic symptoms (fever, lymphangitis, and lymphadenopathy) are present in only about 10% of cases. Complications include bacteremia, endocarditis, and rarely, brain abscesses, myocarditis, pericarditis, renal failure, infectious arthritis, and osteomyelitis. [ID, p. 1638-40; CCDM, p. 508] In one large case series, most of the infections occurred in workers handling crabs. Lymphangitis and lymphadenitis accompany about 1/3 of infections. Low-grade fever and arthralgias are reported in about 10% of infections. Most infections resolve in 3-4 weeks without treatment. Diffuse cutaneous disease is a rare form of erysipeloid. The skin lesions may resemble urticaria, and most patients have fever and arthralgias. Another rare form of the disease is bacteremia. About 70 cases of bacteremia, usually associated with endocarditis, have been reported. [PPID, p. 2497] |
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