| Disease/Syndrome |
Rat-bite fever |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Acute-Severe |
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| Synonyms |
Streptobacillosis (Streptobacillary fever, Haverhill fever, Epidemic arthritic erythema, Rat-bite fever due to Streptobacillus moniliformis); Spirillosis (Spillary fever, Soduku, Rat-bite fever due to Spirillum minus); Ratbite fever |
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| Biomedical References |
Search PubMed |
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| Comments |
EPIDEMIOLOGY: Rat-bite fever is a bacterial infection caused by either Streptobacillus moniliformis or Spirillum minus. Both infections are uncommon in the Americas and Europe. Both have been seen after bites by laboratory or pet rats. Infections have also been reported after bites by squirrels, weasels, and gerbils. The case-fatality rates are about 10%. [CCDM, p. 448-9] S. moniliformis can be cultured from the mouths or nasopharynx of more than 50% of rats. Common-source outbreaks of S. moniliformis infections (Haverhill fever) transmitted by contaminated food, milk, or water have been described. Thirteen cases of human infections were reported in the USA between 1958 and 1983. Most of the S. minus infections are reported in Asia. Only one case has been reported in the USA in the past 31 years. [ID, p. 1736] FINDINGS: Patients present with a history of a rat bite, followed by fever and rash. When the rash appears, the bite wound is usually healed. In streptobacillosis, a maculopapular rash prominent on the extremities, including the palms and soles, appears 1-3 days after onset of the fever. Swelling of large joints is common in streptobacillus infections, and septic arthritis may occur. Other complications are endocarditis, pericarditis, parotitis, tenosynovitis, and abscesses of the skin and brain. The rash of spirillosis is described as reddish or purplish plaques. [CCDM, p. 448-9] Ulceroglandular syndrome (ulceration of the bite site, lymphangitis, and regional lymphadenitis) is a feature of infections by Spirillum minus but not S. moniliformis. In S. minus infections, arthritis is rare, and urticaria is sometimes seen. The rash caused by S. moniliformis may be petechial, vesicular, or pustular. Patients with either infection may have leukocytosis and recurrent fever. Patients with Haverhill fever may have pharyngitis, nausea, and vomiting. Syphilis serology is positive in up to 25% of patients with S. moniliformis and up to 50% of patients with S. minus. [PPID, p. 2708, 2810] |
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| Latency/Incubation |
3-10 days (Streptobacillosis); 1-3 weeks (Spirillosis) |
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| Diagnostic |
S. moniliformis: Culture; Paired sera [CCDM] S. moniliformis: Culture; PCR; Spirillium minus: Microscopic identification of characteristic spirochetes; Xenodiagnosis; [PPID] |
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| ICD-9 Code |
026 |
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| Effective Antimicrobics |
Yes |
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| Reference Link |
MMWR - Fatal Rat-Bite Fever in Florida and Washington, 2003 |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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