RESUMO
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.
Assuntos
Humanos , Animais , Masculino , Feminino , Idoso , Ratos , Osteomielite/etiologia , Febre por Mordedura de Rato/complicações , Articulação Esternoclavicular/diagnóstico por imagem , Mordeduras e Picadas/complicações , Artrite Infecciosa/etiologia , Vértebras Lombares/diagnóstico por imagem , Osteomielite/diagnóstico por imagem , Febre por Mordedura de Rato/diagnóstico , Imageamento por Ressonância Magnética , Artrite Infecciosa/diagnóstico por imagemRESUMO
Abstract Actinomycosis remains characteristically uncommon, but is still an important cause of morbidity. Its clinical presentation is usually indolent and chronic as slow growing masses that can evolve into fistulae, and for that reason are frequently underdiagnosed. Actinomyces spp is often disregarded clinically and is classified as a colonizing microorganism. In this review of literature, we concomitantly present 11 cases of actinomycosis with different localizations, diagnosed at a tertiary hospital between 2009 and 2016. We outline the findings of at least one factor of immunosuppression in > 90% of the reported cases.