title: Rat Bite Fever Resembling Rheumatoid Arthritis.
abstract: Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.
authors.affiliation: Department of Internal Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Ripa
authors.initials: R
authors.lastname: Akter
authors.affiliation: Department of Internal Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Paul
authors.initials: P
authors.lastname: Boland
authors.affiliation: Disciplines of Medicine and Laboratory Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Peter
authors.initials: P
authors.lastname: Daley
authors.affiliation: Department of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Proton
authors.initials: P
authors.lastname: Rahman
authors.affiliation: Eastern Health, St. John's, NL, Canada A1C 5B8.
authors.forename: Nayef
authors.initials: N
authors.lastname: Al Ghanim