Surgical Management of Multijoint Septic Arthritis due to Rat-Bite Fever in a Pediatric Patient: A Case Study

Area of Science:

• Infectious Diseases
• Pediatric Rheumatology
• Zoonotic Infections

Background:

• Rat-bite fever is a rare systemic illness in the US, primarily caused by Streptobacillus moniliformis, found in rodent nasopharyngeal flora.
• Increasing popularity of rodents as pets is leading to more documented pediatric cases.
• Infection can result from exposure to rat excreta, causing fever, rash, and migratory polyarthritis.

Observation:

• This report details a pediatric case of delayed-onset septic arthritis in the wrist and knee.
• The infection was attributed to Streptobacillus moniliformis following a rat bite.
• This presentation differs from previously reported pediatric cases involving only the hip.

Findings:

• Septic arthritis in pediatric patients can manifest in joints beyond the hip.
• Streptobacillus moniliformis is a causative agent for septic arthritis in children following rat bites.
• Prompt diagnosis requires a detailed exposure history, including potential zoonotic sources.

Implications:

• Highlights the importance of considering zoonotic infections in pediatric septic arthritis cases.
• Emphasizes the need for thorough exposure history taking in pediatric patients.
• This case underscores the necessity of antibiotic treatment and surgical intervention for specific presentations of S. moniliformis-induced septic arthritis in children.