Rat-bite fever: An uncommon cause of fever and rash in a 9-year-old patient

Miraflor, Allen P.; Ghajar, Ladan Davallow; Subramaniam, Sathyaseelan; Abreu, Francine B. de; Castanedo-Tardan, Mari Paz; Mann, Julianne A.; Holmes, Alison; Tsongalis, Gregory J.; Yan, Shaofeng

doi:10.1016/j.jdcr.2015.09.008

Cited by 9 publications

(19 citation statements)

References 7 publications

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“…Several other assays are more sensitive than culture for S. moniliformis detection, including gas-liquid chromatography, PCR and 16S-rRNA sequencing [4]. Previously, PCR was used to amplify S. moniliformis genome sequences from the bite site [19], and most cases were identified by 16S-rRNA sequencing.…”

Section: Discussionmentioning

confidence: 99%

“…The resultant PCR product was confirmed by Sanger sequencing. The PCR primers were S5 (CATACTCGGAATAAGATGG) and AS2 (GCTTAGCTCCTCTTTGTAC), which target a S. moniliformis specific region of 16S rRNA [4]. The empirical tazobactam/piperacillin treatment was immediately replaced with penicillin (800,000 IU intravenously every 8 h) for 14 days.…”

Section: Case Presentationmentioning

confidence: 99%

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Rat bite fever caused by Streptobacillus moniliformis infection in a Chinese patient

Zhang

Guo-xin

et al. 2019

BMC Infect Dis

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Background Rat bite fever (RBF), a severe infectious disease, can result from transmission of the pathogen Streptobacillus moniliformis ( S. moniliformis ) by rat bite. RBF diagnosis can be overlooked. Case presentation We present a case of RBF in a Chinese patient who was infected with S. moniliformis in mainland China. Meta-next generation sequencing (mNGS) was used to identify potential pathogens and detected S. moniliformis genome sequences in the pustular sample in less than 72 h. Then the diagnosis was validated by polymerase chain reaction analysis. Despite having severe RBF with complications, this 54-year-old male patient was successfully cured with penicillin as a result of timely pathogen-based diagnosis. Conclusions Physicians should inquire about recent rat exposure and consider the possibility of RBF when a patient develops unexplained fever and rashes. mNGS is a new diagnostic technology and may identify RBF pathogens even when blood culture results are negative.

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Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

Rat bite fever caused by Streptobacillus moniliformis infection in a Chinese patient

Zhang

Guo-xin

et al. 2019

BMC Infect Dis

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“…RBF was first reported in the United States in 1839. In the early 1990s, 2 outbreaks of RBF occurred, and more than 200 cases have been reported in that country ( 4 ). RBF can be caused by two different bacteria: S. moniliformis and S. minus ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Migratory arthralgia is a classical symptom of Streptobacillary RBF, although it is attributed to an asymmetrical pyogenic infection of multiple joints ( 2 ). In some reports, about 1 in 10 rat bites may cause Streptobacillary RBF ( 4 ), and approximately 7-13% of untreated cases are fatal ( 2 ), so the early diagnosis and appropriate treatment are essential for Streptobacillary RBF.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to recognize that blood cultures are sometimes negative in cases of RBF, and other methods, such as PCR, gas-liquid chromatography and 16S-rRNA sequencing, should be considered to confirm these organisms ( 4 ). In addition, because RBF is quite rare in Japan today, it is difficult to diagnose upon the first encounter with this disease.…”

Section: Discussionmentioning

confidence: 99%

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Rat Bite Fever Caused by <i>Streptobacillus moniliformis</i> in a Cirrhotic Patient Initially Presenting with Various Systemic Features Resembling Henoch-Schönlein Purpura

et al. 2018

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We herein report the case of a 61-year-old Japanese cirrhotic patient who developed rat bite fever (RBF) and whose first presentation was serious clinical features mimicking those of Henoch-Schönlein purpura (HSP). In addition to the critical clinical conditions, since the histopathology from purpuric skin eruptions was not inconsistent with that of HSP, therapy with prednisolone was promptly started in order to prevent his death. However, initial blood culture on admission yielded a small and slow-growing bacterial growth, which was gradually revealed by further subculture to be a peculiar bacterium, Streptobacillus moniliformis, leading to a definitive diagnosis of RBF. After the immediate cessation of prednisolone, the patient was treated with a more appropriate antibiotic and consequently made a full recovery. An immunocompromised condition with seriously decompensated liver cirrhosis together with moderately severe chronic kidney disease (CKD) in this patient probably exacerbated the severity of the disease.

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Streptobacillus moniliformis right hand abscess and monoarthritis following a rat bite

Wallemacq

Hing

Mahadeb

et al. 2023

IDCases

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Rat-bite fever: An uncommon cause of fever and rash in a 9-year-old patient

Cited by 9 publications

References 7 publications

Rat bite fever caused by Streptobacillus moniliformis infection in a Chinese patient

Rat bite fever caused by Streptobacillus moniliformis infection in a Chinese patient

Rat Bite Fever Caused by <i>Streptobacillus moniliformis</i> in a Cirrhotic Patient Initially Presenting with Various Systemic Features Resembling Henoch-Schönlein Purpura

Streptobacillus moniliformis right hand abscess and monoarthritis following a rat bite

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