Pet infects teenager with rare rat-bite fever
An adolescent girl was diagnosed with rat-bite fever, a serious but treatable infection, caused by Streptobacillus moniliformis bacteria transmitted by her pet rats, according to a recent report in BMJ Case Report.
“Rat-bite fever is a rare disease caused by a bacterium commonly found in the upper respiratory tract of rodents,” Carina M. Brown, MD, department of family medicine at the University of Virginia “We describe a case of a young woman who suffered oligoarticular arthritis, fevers and rash due to infection by S. moniliformis.”
The patient, aged 17 years, presented to the hospital with persistent lower back and hip pain that caused immobility. During the 2 weeks she was admitted to the hospital, symptoms included fever, nausea, vomiting and a pink rash on her hands and feet. Although she had no medical history or family members with similar symptoms, clinicians discovered that she had three pet rats that lived in her bedroom, one of which died before onset of the patient’s symptoms.
The clinicians performed an MRI on the patient’s hip and sacrum; imaging revealed fluid build-up in the sacroiliac joint and surrounding soft tissue edema. A final diagnosis was reached by culturing this fluid, which grew S. moniliformis after 7 days.
The patient was treated with intravenous Rocephin (ceftriaxone, Hoffmann-La Roche) for 4 weeks, which resolved her symptoms. The clinicians noted that when left untreated, rat-bite fever has a mortality rate of 7% to 13%.
“Rat-bite fever is a treatable zoonosis with a confusing clinical presentation,” Brown and colleagues wrote. “Complete social history taking and a high clinical suspicion in patients with possible exposure is critical for appropriate and timely diagnosis.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.