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Septic arthritis secondary to rat bite fever: a challenging diagnostic course
Basil Budair1, Karan Goswami, Vivek Dhukaram
1Department of Trauma & Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, West Midlands, UK.
BMJ Case Reports
|April 4, 2014
Abstract:
We describe a challenging diagnostic course of a case of septic arthritis secondary to rat bite fever (Streptobacillus moniliformis) in a 29-year-old man who presented with generalised malaise, polyarthralgia and bilateral palmoplantar rash.
Insights
A rare case of septic arthritis caused by rat bite fever (Streptobacillus moniliformis) highlights diagnostic challenges. Early recognition of this infection is crucial for effective treatment and patient outcomes.
Area of Science:
- Infectious Diseases
- Rheumatology
- Dermatology
Background:
- Septic arthritis is a serious joint infection that can lead to rapid joint destruction.
- Rat bite fever is a bacterial infection transmitted through bites or scratches from rodents, primarily rats.
- Streptobacillus moniliformis is the most common bacterial cause of rat bite fever in humans.
Observation:
- A 29-year-old male presented with generalized malaise, polyarthralgia (joint pain), and a distinctive bilateral palmoplantar rash.
- The patient's symptoms were initially non-specific, complicating the diagnostic process.
- Diagnostic workup eventually identified septic arthritis secondary to Streptobacillus moniliformis infection.
Findings:
- The case underscores the importance of considering rat bite fever in the differential diagnosis of septic arthritis, especially with a characteristic rash.
- Microbiological confirmation of Streptobacillus moniliformis is essential for targeted antibiotic therapy.
- Polyarthralgia and rash are key clinical indicators that should prompt further investigation for rat bite fever.
Implications:
- This case highlights the need for increased awareness among clinicians regarding the diverse presentations of rat bite fever.
- Prompt diagnosis and treatment of Streptobacillus moniliformis-induced septic arthritis can prevent long-term joint damage.
- Further research into the epidemiology and clinical manifestations of rat bite fever may improve diagnostic strategies.
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