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Streptobacillus moniliformis mitral valve endocarditis and septic arthritis: the challenges of diagnosing rat-bite

Daisy Torres-Miranda1, Mahdi Moshgriz2, Marc Siegel1

  • 1Department of Medicine, George Washington University, Medical Faculty Associates, Washington, DC.

Infectious Disease Reports
|October 23, 2018
PubMed

Insights

Rat-bite fever (RBF) caused by Streptobacillus moniliformis rarely leads to infectious endocarditis. This case highlights molecular diagnostics on valve tissue for diagnosis when blood cultures are negative.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Streptobacillus moniliformis is the primary cause of rat-bite fever (RBF) in the United States.
  • Infectious endocarditis caused by S. moniliformis is rare, with most prior diagnoses relying on clinical findings and positive blood cultures.
  • Underlying valvular abnormalities are often present in patients with S. moniliformis-related endocarditis.

Purpose of the Study:

  • To report a rare case of native valve endocarditis caused by Streptobacillus moniliformis.
  • To highlight the utility of molecular diagnostics in cases with negative blood cultures.
  • To emphasize the importance of considering S. moniliformis in endocarditis, even without positive blood cultures.

Main Methods:

  • Case report of a patient with native valve endocarditis.
  • Involved molecular diagnostic techniques applied to valvular tissue.
  • Valvular vegetation was identified on the mitral valve.

Main Results:

  • The patient presented with a mitral valve vegetation.
  • Blood cultures were negative for S. moniliformis.
  • Molecular diagnostics on valvular tissue confirmed the presence of S. moniliformis.

Conclusions:

  • Streptobacillus moniliformis can cause native valve endocarditis.
  • Molecular diagnostics are crucial for diagnosing S. moniliformis endocarditis when blood cultures are negative.
  • This case expands the understanding of S. moniliformis as a cause of infectious endocarditis.
Keywords:
EndocarditisStreptobacillus moniliformis.rat bite fever

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