title: A Case Study of Rat Bite Fever Caused by Streptobacillus moniliformis.
abstract: We report a case of rat bite fever, diagnosed based on positive cultures of Streptobacillus moniliformis from blood and synovial fluid. The patient was a 45-year-old man who presented with history of a rat bite and alcoholic liver cirrhosis. He had been bitten on his third finger by a rat, which was caught in a mousetrap installed in his house. Over the course of approximately 2 weeks after the bite, the patient developed fever, rash, and arthralgia. The patient was admitted to our hospital and treated with a combination of ampicillin-sulbactam, vancomycin (VAN), and minocycline (MIN) antibiotics. Initial culture findings from the Anaerobic/F resin blood culture were positive for gram-negative bacillus after overnight incubation. Thus, S. moniliformis infection was suspected, and administration of VAN and MIN was ceased. On hospital day 8, the treatment was switched to oral amoxicillin-clavulanic acid, and the patient was discharged from the hospital. Subsequently, the pathogen was also detected in synovial fluid and identified as S. moniliformis using 16S rRNA sequencing analysis.
authors.affiliation: Department of Clinical Laboratory, National Hospital Organization Nagoya Medical Center.
authors.forename: Yasue
authors.initials: Y
authors.lastname: Hayakawa
authors.affiliation: Division of General Internal Medicine, National Hospital Organization Nagoya Medical Center.
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.affiliation: Laboratory and Bacteriology, Aichi Prefectural Institute of Public Health.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Immunology and Infectious Diseases, Clinical Research Center, National Hospital Organization Nagoya Medical Center.
authors.forename: Wataru
authors.initials: W
authors.lastname: Sugiura
authors.affiliation: Department of Microbiology, Tokyo Medical University.
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Ohkusu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D001769:Blood / Q000382:microbiology; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D011906:Rat-Bite Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D017422:Sequence Analysis, DNA; D013288:Streptobacillus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D013582:Synovial Fluid / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S
keywords: 16S rRNA sequencing; Streptobacillus moniliformis; rat bite fever