ABSTRACT
BACKGROUND: Rat bite fever and Haverhill fever are caused by Streptobacillus moniliformis which is part of the natural oral flora of rats and other rodents. Fever accompanied by headache, nausea and myalgia develops within ten days. Complications can be fatal. MATERIAL AND METHODS: A case of rat bite fever is described. A 48-year-old woman developed fever and malaise five days after being bitten by a pet rat. Two days later rash and arthritis in the hand and feet developed. Erythromycin was administered without effect. Ten days after the bite the patient was admitted to hospital and recovered after two weeks of intravenous penicillin therapy. RESULTS: S moniliformis was isolated from blood culture. On admission CRP was 231, ESR 88, ASAT 87, ALAT 218 and gamma-GT 461. Laboratory results normalized after therapy. INTERPRETATION: In cases of fever after rodent bites, S moniliformis infection should always be considered. Diagnosis is made by blood culture or cultivation from pus from the bite wound. First choice therapy is penicillin, or in case of intolerance, tetracycline.
Subject(s)
Rat-Bite Fever , Animals , Animals, Domestic , Diagnosis, Differential , Female , Humans , Middle Aged , Rat-Bite Fever/drug therapy , Rat-Bite Fever/microbiology , Rat-Bite Fever/pathology , Rats , Streptobacillus/isolation & purificationABSTRACT
The clinical efficacy and tolerance of a combination of benzoyl peroxide 5% and miconazole 2%, Acnidazil, for the treatment of facial acne vulgaris have been compared with those of tretinoin 0.05% in a double-blind study with 40 patients during 12 weeks. The combination of benzoyl peroxide and miconazole gave improvement in 82% of 22 patients, compared to tretinoin which gave improvement in 50% of 18 comparable patients. The difference is significant. Also, side-effects were significantly less in the benzoyl-miconazole group than in the tretinoin group.
