Rat Bite Fever Resembling Rheumatoid Arthritis

Area of Science:

• Infectious Diseases
• Rheumatology
• Zoonotic Infections

Background:

• Rat bite fever is uncommon in Western countries and challenging to diagnose due to negative blood cultures and often missed rodent exposure history.
• Polyarthritis associated with rat bite fever can be misdiagnosed as rheumatoid arthritis without a high index of suspicion.

Purpose of the Study:

• To report a case of culture-positive rat bite fever with unusual presentation and complications.
• To discuss the diagnostic and management challenges of this rare zoonotic infection.
• To review existing literature on rat bite fever cases with initial rheumatological diagnoses.

Main Methods:

• Case report of a 46-year-old female with fever and polyarthritis.
• Review of nine previously reported cases of rat bite fever.
• Analysis of diagnostic and management strategies.

Main Results:

• The patient presented with fever and polyarthritis, clinically resembling rheumatoid arthritis.
• The infection was complicated by discitis, a rare manifestation of rat bite fever.
• All reviewed cases initially presented with symptoms suggestive of rheumatological disorders.

Conclusions:

• Rat bite fever requires a high index of suspicion for timely diagnosis, especially when presenting as polyarthritis.
• Prompt treatment is essential as rat bite fever is curable but can be lethal if untreated.
• Discitis is a rare but possible complication of rat bite fever.