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Rat Bite Fever: It's Still a Threat
Alexander J Bergeson1, Kyler A Hardie2, Robert E Van Demark1
1Sanford School of Medicine (SSOM), University of South Dakota, Vermillion, SD.
Abstract:
Streptobacillus moniliformis is considered normal flora of the upper respiratory tract of rodents and is the predominant cause of rat bite fever in North America. Although patients with rat bite fever oftentimes present with migratory polyarthralgia, cultures of affected joints do not grow bacteria in the vast majority of cases. We present a case of a 32-year-old woman who initially presented with a painful, swollen right index finger proximal interphalangeal (PIP) joint following a bite from her pet rat. After initial treatment with empiric antibiotics did not clear the infection, PIP joint irrigation and debridement revealed culture-positive septic arthritis. This case illustrates the patient's unusual presentation of S. moniliformis infection through septic arthritis of the PIP joint.
Insights
Streptobacillus moniliformis, a common rodent bacterium, can cause rat bite fever. This case highlights a rare instance of septic arthritis in a finger joint, confirmed by joint fluid cultures after initial antibiotic treatment failed.
Area of Science:
- Infectious Diseases
- Bacteriology
- Rheumatology
Background:
- Streptobacillus moniliformis is a normal inhabitant of rodent respiratory tracts.
- It is the primary cause of rat bite fever in North America.
- Joint involvement in rat bite fever typically presents as migratory polyarthralgia, often with negative joint cultures.
