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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

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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

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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]


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