title: [Unexplained fever after exposure to rats: rat bite fever or Haverhill fever].
abstract: A 24-year old man presented himself to the emergency ward with complaints of fever, nausea, headache, muscle ache and chest pain. Two weeks before presentation he had been bitten by a pet rat. We determined that he had bacteraemia caused by a Streptobacillus moniliformis infection, which led to the development of an illness called rat bite fever. S. moniliformis is a pleomorphic gram-negative rod-shaped bacterium that is considered part of the normal nasopharyngeal flora in rats. It is the cause of two similar illnesses: rat bite fever and Haverhill fever. Clinicians should consider these infections in the work-up of unexplained fever or sepsis, certainly in the presence of known exposure to rats. Treatment consists of antibiotics.
authors.affiliation: Maastricht University Medical Centre, afd. Algemene Interne Geneeskunde, Maastricht, the Netherlands. k.hurkens@mumc.nl
authors.forename: Kim P G M
authors.initials: KP
authors.lastname: Hurkens
authors.forename: Evelien
authors.initials: E
authors.lastname: Pijpers
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001733:Bites and Stings; D006801:Humans; D008297:Male; D011906:Rat-Bite Fever / Q000175:diagnosis* / Q000188:drug therapy; D051381:Rats; D013288:Streptobacillus / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents