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Published on: August 31, 2013
Rat bite fever: a misnomer?
Peter James Glasman1, Adrian Thuraisingam
1Arrowe Park Hospital, Gastroenterology, c/o Dr Thuraisingam's Secretary, Arrowe Park Road, Upton, Merseyside CH49 5PE, UK.
Abstract:
We report a case of rat bite fever (Streptobacillus moniliformis) in a young man who presented generally unwell with pyrexia, vomiting, arthralgia and deranged liver function. Two weeks before his illness he had disposed of a dead rat but was not bitten by it. This zoonotic infection was treated with broad spectrum antibiotics and he made a complete recovery. It is a rarely diagnosed but likely common infection given the frequent contact between humans and rodents. In the past, confirmation of the organism has been difficult due its dislike of culture mediums, but the advent of polymerase chain reaction (PCR) testing has allowed reliable isolation. Appropriate treatment is important because there is an associated mortality from secondary endocarditis.
Insights
Rat bite fever, caused by Streptobacillus moniliformis, is a rare but potentially common zoonotic infection. Prompt antibiotic treatment leads to complete recovery and prevents serious complications like endocarditis.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Rat bite fever is a zoonotic disease transmitted from rodents to humans.
- Streptobacillus moniliformis is the causative agent, often difficult to culture.
- Human-rodent contact is frequent, suggesting underdiagnosis of this infection.
Purpose of the Study:
- To report a case of rat bite fever in a young man.
- To highlight diagnostic challenges and advancements.
- To emphasize the importance of timely treatment.
Main Methods:
- Clinical case presentation of a young man with symptoms including fever, vomiting, joint pain, and abnormal liver function.
- Review of patient's history for potential exposure to rodents.
- Treatment with broad-spectrum antibiotics.
- Mention of polymerase chain reaction (PCR) as a reliable diagnostic tool.
Main Results:
- The patient recovered completely after antibiotic treatment.
- The infection was linked to handling a dead rat, without a direct bite.
- PCR testing facilitates reliable identification of Streptobacillus moniliformis.
Conclusions:
- Rat bite fever is an underdiagnosed zoonotic infection.
- Early diagnosis and appropriate antibiotic therapy are crucial for patient recovery.
- Advancements in molecular diagnostics like PCR improve detection rates.
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