ABSTRACT
Abstract Rat-bite fever is a rarely diagnosed illness caused by Streptobacillus moniliformis . Although this disease is distributed worldwide, there have been few cases reported in Europe. Here, we report a case of vertebral osteomyelitis and sternoclavicular septic arthritis caused by S. moniliformis in a Portuguese patient previously bitten by a rat. Laboratory diagnosis was performed using molecular identification. This is the first case report of rat-bite fever in Portugal. The case described here serves as a reminder for physicians to consider this diagnosis in patients who have developed fever syndromes after being in contact with rodents.
Subject(s)
Humans , Animals , Male , Female , Aged , Rats , Osteomyelitis/etiology , Rat-Bite Fever/complications , Sternoclavicular Joint/diagnostic imaging , Bites and Stings/complications , Arthritis, Infectious/etiology , Lumbar Vertebrae/diagnostic imaging , Osteomyelitis/diagnostic imaging , Rat-Bite Fever/diagnosis , Magnetic Resonance Imaging , Arthritis, Infectious/diagnostic imagingABSTRACT
Rat-bite fever is an uncommon disease known for its endemicity to occur worldwide. Although most patients tend to develop mild symptoms with improvement from conventional antibiotics, it can progress with severe complications with a mortality rate as high as 13% without proper treatment. The authors report a complicated case of rat bite-fever involving a 61-year old woman who presented with fever petechial rash, and septic arthritis following a rat bite. Initially, multiple antibiotics were administered but were not effective. As a consequence, invasive procedures such as arthrotomy and joint debridement were done and prolonged antibiotic was administered until clinical resolution. Since many cases do not have a history of rat bite and may present with fever, rashes, and arthritis it is essential to distinguish it from other diseases. Here, the authors will provide details on the etiology, clinical manifestations, diagnosis, and management to aid prompt detection and treatment of the disease.
Subject(s)
Arthritis, Infectious/microbiology , Exanthema/microbiology , Female , Humans , Middle Aged , Rat-Bite Fever/diagnosisABSTRACT
Numerosas afecciones son transmitidas al hombre por diferentes vectores, sean éstos insectos, pájaros o mamíferos. Entre las transmitidas por estos últimos, en la presente revisión se abordaron: la enfermedad por mordedura de rata que es básicamente un cuadro febril agudo, intenso, de comienzo brusco y de evolución recurrente y la enfermedad por rasguño de gato que se manifiesta por adenopatías sin signos inflamatorios locales, de lenta evolución regresiva y con escasa repercusión sobre el estado general. Ambas afecciones son más comunes en nuestro medio de lo que habitualmente se piensa y responden favorablemente a diversos antibióticos pero inicialmente plantean, con frecuencia, problemas de diagnóstico diferencial con enfermedades de pronóstico más grave
Subject(s)
Humans , Cat-Scratch Disease/diagnosis , Rat-Bite Fever/diagnosis , Anti-Bacterial Agents/therapeutic use , Cat-Scratch Disease/drug therapy , Cat-Scratch Disease/etiology , Diagnosis, Differential , Prognosis , Rat-Bite Fever/drug therapy , Rat-Bite Fever/etiology , Spirillum/pathogenicity , Streptobacillus/pathogenicityABSTRACT
A febre por mordida de rato resulta de uma infecçäo causada pelo spirillum minus. Os autores descrevem um caso de paciente com febre, astenia e úlcera na regiäo frontal esquerda, após exposiçäo a um roedor. O microorganismo foi identificado através de exame em campo escuro de material obtido exsudado da úcera. A penicilina foi utilizada, com total regressäo dos sintomas