Rat-bite fever is an uncommon bacterial illness resulting from infection with 
Streptobacillus moniliformis that is often transmitted by the bite of a rat. The 
cutaneous findings in rat-bite fever are nonspecific but have been described as 
maculopapular or petechial. We describe a 9-year-old girl with acrally 
distributed hemorrhagic pustules, fever, and arthralgias. Diagnosis was delayed 
because of difficulty in identifying the pathologic organism. She was 
successfully treated with 10 days of ceftriaxone.