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Streptobacillus moniliformis septic arthritis: a clinical entity distinct from rat-bite fever?

Teresa K F Wang1, Samson S Y Wong

  • 1Department of Microbiology, Research Centre of Infection and Immunology, The University of Hong Kong, Queen Mary Hospital, Hong Kong. tkfwang@hkucc.hku.hk <tkfwang@hkucc.hku.hk>

BMC Infectious Diseases
|June 15, 2007
PubMed
Abstract

Insights

Streptobacillus moniliformis can cause septic arthritis, distinct from rat-bite fever. Early diagnosis through patient history and joint fluid analysis is crucial for effective treatment and good prognosis.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Microbiology

Background:

  • Streptobacillus moniliformis is a zoonotic bacterium linked to rodents.
  • It commonly causes rat-bite fever but can also lead to septic arthritis.

Observation:

  • A case of streptobacillary septic arthritis in the knee and wrist is presented.
  • A review of 11 cases highlights common features: rat exposure (91.6%), knee involvement (58.3%), and polyarticular disease (83.3%).
  • Fever and rash are less common in septic arthritis than in rat-bite fever.

Findings:

  • Streptobacillus moniliformis bacteremia is rare (8.4%), with a generally good prognosis.
  • Arthrocentesis aids in differentiating septic arthritis from reactive arthritis.
  • Specific culture media may inhibit S. moniliformis growth.

Implications:

  • Eliciting a detailed rodent exposure history is vital for diagnosing streptobacillary infections.
  • Understanding the differences between rat-bite fever and septic arthritis improves clinical management.
  • Accurate microbiologic diagnosis is essential for appropriate antibiotic therapy.

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