Rat-Bite Fever

Washburn, Ronald G.

doi:10.1016/b978-1-4557-4801-3.00233-2

Cited by 3 publications

(5 citation statements)

References 70 publications

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“…2 Courses complicated by myocarditis, endocarditis, pneumonitis, meningitis, and hepatic involvement hold a higher mortality rate of up to 53% if endocarditis is present. 2 The treatment for patients without endocarditis is penicillin G. 1 After resolution, the palms and soles desquamate, and the migratory arthritis may continue for years. 4,5 Streptobacillus moniliformis is an aerobic, gram-negative rod that requires microaerophilic culture conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Rat bite fever is a rare acute systemic illness caused by inoculation with S moniliformis or Spirillum minus , which is found in Asia and is characterized by transmission site ulceration, large lymphadenopathy, and absence of arthritis . Streptobacillus moniliformis lacks these features and is more commonly reported in North America and Europe.…”

Section: Discussionmentioning

confidence: 99%

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Petechiae, Purpura, and Hemorrhagic Vesicles

2017

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A man in his 70s was admitted to the hospital with encephalopathy, recent falls, leukocytosis, nausea, and arthralgias. On presentation to the emergency department, he received antibiotics owing to a concern for aspiration pneumonia. He underwent a stroke workup, including transesophageal echocardiography (TEE), results of which were negative. He was noted to have a progressing cutaneous eruption during his admission, and the dermatology department was consulted. He was found to have scattered petechiae and hemorrhagic vesicles, with most concentrated on the hands and feet (Figure , A and B). Palpable purpura were noted across the extremities. Several lesions were studded with pustules. He had an enlarging bulla on his left wrist. An abrasion on his left elbow was attributed to his recent falls. The infectious disease department was also consulted, and the patient was given broad-spectrum antibiotics owing to concern about endocarditis. As part of his dermatological workup, two 4-mm punch biopsy specimens were obtained (Figure, C and D). One was sent for histopathological examination, and the other was sent for fungal, bacterial, and mycobacterial cultures. A bacterial culture swab was obtained from the tense bulla on his left wrist.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Petechiae, Purpura, and Hemorrhagic Vesicles

2017

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“…5 Nearly 20,000 rat bites occur annually in the United States, and an estimated 10% result in infection. 7,8 S. moniliformis is a commensal organism in the upper respiratory tract of rodents, colonizing 10%-100% of domesticated rats. 8,9 Clinical symptoms develop 2-21 days after exposure, 5,6 with fever, myalgias, and headache preceding the development of migratory poly-arthralgia or -arthritis and rash.…”

Section: E T T E R T O T H E E D I T O R Oh Rats! Intracellular Rod-l...mentioning

confidence: 99%

“…7,8 S. moniliformis is a commensal organism in the upper respiratory tract of rodents, colonizing 10%-100% of domesticated rats. 8,9 Clinical symptoms develop 2-21 days after exposure, 5,6 with fever, myalgias, and headache preceding the development of migratory poly-arthralgia or -arthritis and rash. The rash is most prominent on the extremities and may involve palmar surfaces.…”

Section: E T T E R T O T H E E D I T O R Oh Rats! Intracellular Rod-l...mentioning

confidence: 99%

“…A relapsing febrile pattern may follow the initial illness in the absence of treatment, though the initial phase carries the highest risk of mortality, approaching 13% without treatment. [8][9][10][11][12] S. moniliformis is difficult to recover with standard blood culture techniques. 5,10 Metagenomic next-generation sequencing of microbial cell-free DNA from plasma through Karius Inc provided a rapid, noninvasive confirmation.…”

Section: E T T E R T O T H E E D I T O R Oh Rats! Intracellular Rod-l...mentioning

confidence: 99%

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Oh rats! Intracellular rod‐like inclusions in an adolescent with Shwachman–Diamond syndrome

Mayhew,

Luttrell,

Barros

et al. 2024

Pediatric Blood & Cancer

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Rat-Bite Fever Due to <i>Streptobacillus moniliformis</i> in a Patient without Bite History: an Unexpected Cause of Consciousness Disturbance

Oda¹,

Uekita²,

Watanabe³

et al. 2020

Jpn J Infect Dis

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Rat-bite fever (RBF) is a zoonotic disease caused by direct contact with rats harboring Streptobacillus moniliformis, Streptobacillus notomytis, or Spirillum minus (1,2). Few studies have reported RBF cases. Therefore, the incidence of RBF is not well understood in Japan. The mortality rate is approximately 10 in undertreated RBF cases (1,3). Of the 3 bacterial causes, S. moniliformis infection typically presents as a triad of relapsing fever, polyarthralgia, and skin rash along with severe diseases, including pneumonia, meningitis, and endocarditis (3). Generally, a history of rat bite is an important clue for RBF diagnosis. However, we encountered a case of RBF caused by S. moniliformis infection without rat bite. In September 2016, a 76-year-old Japanese male patient living in a rural area in Okitama district, Yamagata Prefecture, Japan, was referred to our hospital because of consciousness disturbance. He had a history of diabetes mellitus treated with oral antidiabetic agents. Upon physical examination, the patient was febrile (37.3 C) and disoriented (Glasgow Coma Scale 14; E4V4M6). His blood pressure, heart rate, and percutaneous oxygen saturation in room air were 161 104 mmHg, 92 bpm, and 95 , respectively. He complained of right elbow and left hip joint pain without evidence of bruises or abrasions and no limitation of movement. He had no skin rash or other findings suggestive of meningitis or cerebral apoplexy such as headache, nuchal rigidity, and extremity paralysis. His cardiovascular and respiratory findings were normal. Hematological assessment revealed white blood cell count and C-reactive protein level of 18,690 μL and 5.5 mg dL, respectively. Renal and thyroid functions as well as levels of liver enzymes, electrolytes, blood glucose, and serum ammonia were within normal ranges. Antinuclear antibody tests were negative whereas semiquantitative procalcitonin protein was 1+ (Table 1).

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Rat-Bite Fever

Cited by 3 publications

References 70 publications

Petechiae, Purpura, and Hemorrhagic Vesicles

Petechiae, Purpura, and Hemorrhagic Vesicles

Oh rats! Intracellular rod‐like inclusions in an adolescent with Shwachman–Diamond syndrome

Rat-Bite Fever Due to <i>Streptobacillus moniliformis</i> in a Patient without Bite History: an Unexpected Cause of Consciousness Disturbance

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