DISCUSSION Erysipelothrix rhusiopathiae (formerly known as E. insidosa) is a nonmotile, non sporulating, nonencapsulated gram-positive microarophilic bacillus. This slowgrowing organism tends to become pleomorphic and gram negative on prolonged incubation ~, and it can be mistaken for Haernophilus in)quenzae on Gram smear. Poultry, fish, crab, and swine are frequently infected. Direct swine to man contact is the most significant mode of acquisition, whereas direct perSon-to-person transmission is rare. Erysipeloid is usually an occupational disease of butchers and fishermen. Typically, one to seven days after an exposure to meat or fish products, a red maculopapular lesion appears. lesion progresses by centrifugal spreading and central clearing, taking on a target-shaped appearance with a normal center, a bluish ring, and sometimes a red peripheral halo. differential diagnosis includes H. influenzae cellulitis and erysipelas. Hoeprich:' states, The clinical appearance of erysipeloid is unique; once seen, the disease will always be recognized when encountered again. Usually there is no fever or leukocytosis, and the disease subsides spontaneously in three weeks. However, septicemia, septic arthritis, and endocarditis are occasional complications. appearance of the skin lesion in this case was typical. We recovered E. rhusipathiae from an aspirate of the center of the lesion, but it is usually recommended to obtain the specimen from the margin? ~' We found only one other case report in the pediatric literature? fever and elevated blood count in our patient suggest a more severe involvement in this age group. prognosis is good in adults with or without treatment, but penicillin therapy is advised3; we believe that this recommendation is especially warranted in infants.