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Rat-bite fever as a cause of septic arthritis: a diagnostic dilemma
R L Rumley1, N A Patrone, L White
1Section of Infectious Diseases, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354.
Abstract:
Rat-bite fever results from an infection with the organism Streptobacillus moniliformis. Symptomatic patients often present with fever, malaise, cough, maculopapular rash, and occasional arthritis, and usually have a history of rodent exposure. This report describes a patient with rat-bite fever resulting in suppurative arthritis. The patient's diagnosis was made by culture of S moniliformis from his left wrist. The diagnosis was delayed, however, owing to the lack of an exposure history, atypical clinical presentation, and the unusual microbiologic characteristics shown by this organism.
Insights
Rat-bite fever, caused by Streptobacillus moniliformis, can lead to severe joint infections. Early diagnosis is crucial, even with atypical symptoms and no clear rodent exposure history.
Area of Science:
- Infectious Diseases
- Microbiology
Background:
- Rat-bite fever is caused by Streptobacillus moniliformis.
- Typical symptoms include fever, rash, and arthritis, often linked to rodent exposure.
Observation:
- This case report details a patient with rat-bite fever presenting with suppurative arthritis.
- Diagnosis was confirmed by culturing S moniliformis from wrist joint fluid.
Findings:
- The patient's diagnosis was delayed due to a lack of reported rodent exposure.
- Atypical clinical presentation and unusual microbial characteristics of S moniliformis contributed to diagnostic challenges.
Implications:
- Highlights the importance of considering rat-bite fever in cases of unexplained arthritis, even without a clear exposure history.
- Underscores the need for awareness of Streptobacillus moniliformis's diverse presentations and diagnostic nuances.