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Rat-bite fever identified by polymerase chain reaction detection of Streptobacillus moniliformis DNA

Daiki Nakagomi1, Nobuhiro Deguchi, Akiko Yagasaki

  • 1Department of Dermatology, University of Yamanashi, Chuo-shi, Yamanashi, Japan. dnakagomi@yamanashi.ac.jp

The Journal of Dermatology
|November 20, 2008
PubMed

Insights

A rat bite led to rat-bite fever in a 74-year-old woman. Diagnosis was confirmed by polymerase chain reaction on a skin lesion, with piperacillin sodium effectively treating the infection.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Diagnostics

Background:

  • Rat-bite fever (RBF) is a bacterial infection transmitted by rodents.
  • Diagnosis often relies on clinical presentation and culture, which can be slow.
  • Emerging diagnostic tools offer potential for faster and more accurate identification.

Observation:

  • A 74-year-old female presented with fever, arthralgia, and erythema after a rat bite.
  • Initial treatment with minocycline led to symptom remission but was followed by relapse.
  • Polymerase chain reaction (PCR) detected Streptobacillus moniliformis DNA in a crusted skin lesion.

Findings:

  • This case represents the first diagnosis of rat-bite fever using PCR on a crusted skin lesion.
  • PCR confirmed the presence of Streptobacillus moniliformis, the causative agent of RBF.
  • Piperacillin sodium therapy resulted in complete resolution of fever and arthralgia.

Implications:

  • PCR on skin lesions offers a novel, rapid diagnostic approach for rat-bite fever.
  • Early and accurate diagnosis is crucial for effective treatment and preventing complications.
  • This case highlights the importance of considering RBF in patients with relevant exposure and symptoms.

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