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Rat-bite Fever: A Rare Diagnosis for a Common Pediatric Presentation: Case Report
Anthony Edholm1, Marissa Heyer2, Sondra M Nemetski3,4
1Hackensack University Medical Center, Department of Emergency Medicine, Hackensack, New Jersey.
Clinical Practice and Cases in Emergency Medicine
|November 23, 2021
Summary
A rare zoonotic illness, rat-bite fever (Streptobacillus moniliformis), can occur without a direct rodent bite. Early identification through detailed history and physical examination is crucial for prompt antibiotic treatment and prevention.
Area of Science:
- Pediatrics
- Infectious Diseases
- Dermatology
Background:
- Fever and rash presentations are common in pediatric emergency departments, posing diagnostic challenges.
- Rat-bite fever is a severe zoonotic illness with symptoms including relapsing fever, rash, and joint pain.
- This case highlights a rare instance of S. moniliformis infection without a documented rodent bite.
Purpose of the Study:
- To report a case of rat-bite fever caused by Streptobacillus moniliformis.
- To emphasize the importance of thorough patient history and physical examination in diagnosing rare zoonotic diseases.
- To underscore the need for considering non-bite-related exposures in pediatric fever and rash cases.
Main Methods:
- A detailed medical history and physical examination were performed.
- Diagnostic workup was conducted to identify the causative pathogen.
- Treatment was initiated based on the confirmed diagnosis.
Main Results:
- Streptobacillus moniliformis was identified as the causative agent.
- The patient received appropriate antibiotic treatment.
- Successful management of the rare zoonotic exanthem was achieved.
Conclusions:
- Clinicians must inquire about zoonotic exposures due to the non-specific presentation of rat-bite fever.
- The increasing prevalence of pet rodents necessitates a broader differential diagnosis for fever and rash.
- Prompt identification and treatment are vital for managing this potentially fatal illness.
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