title: Oh rats! Fever, rash and arthritis in a young woman.
abstract: A 17-year-old girl presented with worsening right-sided hip and low back pain for 2 days. She had also experienced intermittent fevers and a recurring maculopapular rash over the past 2 weeks. Social history revealed the presence of three domestic rats living in the girl's home. Blood cultures returned positive for Streptobacillus moniliformis, the causative agent of rat-bite fever. Rat-bite fever often goes undiagnosed, as the clinical presentation is non-specific. Untreated, the infection can result in death due to sepsis or endocarditis. The bacterium is generally susceptible to penicillin antibiotics with full clinical recovery when treated in a timely and appropriate manner. After 4 weeks of intravenous antibiotics, our patient fully recovered without long-term sequelae.
authors.affiliation: Department of Family Medicine, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Carina M
authors.initials: CM
authors.lastname: Brown
authors.affiliation: Department of Family Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Tsai
authors.affiliation: Department of Pediatrics, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
authors.forename: Xavi
authors.initials: X
authors.lastname: Sanchez-Flores
mesh_terms: D000293:Adolescent; D000818:Animals; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000209:etiology; D001733:Bites and Stings / Q000150:complications / Q000382:microbiology*; D004777:Environment; D005076:Exanthema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use*; D011906:Rat-Bite Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D051381:Rats; D013288:Streptobacillus / Q000254:growth & development*; D015047:Zoonoses / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology
chemical_list: D010406:Penicillins