[Rat-bite fever].
BACKGROUND
Rat bite fever and Haverhill fever are caused by Streptobacillus moniliformis which is part of the natural oral flora of rats and other rodents. Fever accompanied by headache, nausea and myalgia develops within ten days. Complications can be fatal.


METHODS
A case of rat bite fever is described. A 48-year-old woman developed fever and malaise five days after being bitten by a pet rat. Two days later rash and arthritis in the hand and feet developed. Erythromycin was administered without effect. Ten days after the bite the patient was admitted to hospital and recovered after two weeks of intravenous penicillin therapy.


RESULTS
S moniliformis was isolated from blood culture. On admission CRP was 231, ESR 88, ASAT 87, ALAT 218 and gamma-GT 461. Laboratory results normalized after therapy.


CONCLUSIONS
In cases of fever after rodent bites, S moniliformis infection should always be considered. Diagnosis is made by blood culture or cultivation from pus from the bite wound. First choice therapy is penicillin, or in case of intolerance, tetracycline.
Grude
N
N
Telelab, Postboks 1868 Gulset, 3703 Skien. nils.grude@telelab.no
Tveten
Y
Y
Torp
P Ø
PØ
Laastad
O
O
D000818:Animals; D000829:Animals, Domestic; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D011906:Rat-Bite Fever / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D051381:Rats; D013288:Streptobacillus / Q000302:isolation & purification