A 53-year-old butcher sought care for a painful, red area on his hand that had developed three days earlier. The rash appeared after an accidental cut while processing meat, and examination showed erythematous vesiculated papules and plaques with edema on the hand and fingers. The patient was otherwise well, with no systemic symptoms or recent travel.
A gram stain of fluid from a vesicle revealed gram-positive rods. In the context of occupational exposure to raw meat, this narrows the differential to zoonotic infections such as erysipeloid, orf, and related conditions. The quiz lists angioedema, arthropod bite, erysipeloid, and orf as options, with erysipeloid being the classic consideration for meat handlers.
The source presents this as a diagnostic challenge and does not explicitly confirm the final diagnosis. Still, the case underscores how a focused occupational history and a simple gram stain can guide the workup of a hand infection. Clinicians evaluating similar presentations should keep zoonotic pathogens in mind, especially when patients report handling meat or fish.