title: Rat bite fever without fever.
abstract: Rat bite fever is a rarely reported acute febrile bacterial illness caused by Streptobacillus moniliformis or Spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. Diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.
authors.affiliation: Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Stehle
authors.forename: O
authors.initials: O
authors.lastname: Dubuis
authors.forename: A
authors.initials: A
authors.lastname: So
authors.forename: J
authors.initials: J
authors.lastname: Dudler
mesh_terms: D000368:Aged; D000818:Animals; D001168:Arthritis / Q000382:microbiology*; D001733:Bites and Stings / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008297:Male; D011906:Rat-Bite Fever / Q000175:diagnosis*; D051381:Rats; D013288:Streptobacillus; D013582:Synovial Fluid / Q000382:microbiology