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Section 3. Summaries of Infectious Diseases
Rat-Bite Fever
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Rat-bite fever is caused by
Streptobacillus moniliformis or
Spirillum minus. Streptobacillus moniliformis infection (streptobacillary fever or Haverhill fever) is characterized
by fever, rash, and arthritis. There is an abrupt onset of fever,
chills, muscle pain, vomiting, headache, and occasionally, adenopathy.
A maculopapular or petechial rash develops, predominantly on
the extremities, typically within a few days of fever onset.
The bite site usually heals promptly and exhibits no or minimal
inflammation. Nonsuppurative migratory polyarthritis or arthralgia
follows in approximately 50% of patients. Untreated infection
usually has a relapsing course for a mean of 3 weeks. Ulceration
at the initial bite wound and regional lymphadenopathy do not
occur. Complications include soft tissue and solid-organ abscesses,
pneumonia, endocarditis, myocarditis, and meningitis. The case-fatality
rate is 7% to 10% in untreated patients. With
S minus infection,
a period of initial apparent healing at the site of
. . . [Go to Full Text]
Related text in Red Book:
- Introduction
Red Book
2006: 735.
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