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'''For patient information click [[Rat-bite fever (patient information)|here]]'''
'''This page is about clinical aspects of the disease.  For microbiologic aspects of specific causative organisms:'''
{{Seealso|Streptobacillus moniliformis}}
{{Seealso|Spirillum minus}}
{{Rat-bite fever}}
{{Rat-bite fever}}


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==[[Rat-bite fever causes|Causes]]==
==[[Rat-bite fever causes|Causes]]==
Normal commensal of rodent oropharynx also in ferrets, weasels, gerbils.
Risk factors for acquisition: crowded urban dwellings (especially kids), lab workers.
Transmission: bite/scratch from rat, mice, squirrels—also cats, dogs, pigs.


==[[Rat-bite fever differential diagnosis|Differentiating Rat-bite fever from other Diseases]]==
==[[Rat-bite fever differential diagnosis|Differentiating Rat-bite fever from other Diseases]]==
Differential diagnosis: rash on palms/soles consider RMSF, syphilis. Arthritis: disseminated gonorrhea, Lyme, brucella, endocarditis, rheumatological dz, and rheumatic fever.


==[[Rat-bite fever natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==[[Rat-bite fever natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
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==Diagnosis==
==Diagnosis==
[[Rat-bite fever history and symptoms|History and Symptoms]] | [[Rat-bite fever physical examination|Physical Examination]] | [[Rat-bite fever laboratory findings|Laboratory Findings]] | [[Rat-bite fever imaging findings|Imaging Findings]] | [[Rat-bite fever other diagnostic studies|Other Diagnostic Studies]]
[[Rat-bite fever history and symptoms|History and Symptoms]] | [[Rat-bite fever physical examination|Physical Examination]] | [[Rat-bite fever laboratory findings|Laboratory Findings]] | [[Rat-bite fever imaging findings|Imaging Findings]] | [[Rat-bite fever other diagnostic studies|Other Diagnostic Studies]]
* '''Diagnosis''': Gram or Giemsa stain blood, joint fluid, pus. Perform culture using TSA or blood agar. ELISA or agglutinins (sero-negative within 5 months-2 yrs); PCR.


==Treatment==
==Treatment==
[[Rat-bite fever medical therapy|Medical Therapy]] | [[Rat-bite fever primary prevention|Prevention]]  | [[Rat-bite fever cost-effectiveness of therapy|Cost-effectiveness of Therapy]] | [[Rat-bite fever future or investigational therapies|Future or Investigational Therapies]]
[[Rat-bite fever medical therapy|Medical Therapy]] | [[Rat-bite fever primary prevention|Prevention]]  | [[Rat-bite fever cost-effectiveness of therapy|Cost-effectiveness of Therapy]] | [[Rat-bite fever future or investigational therapies|Future or Investigational Therapies]]


::* (1) Migratory arthropathy and arthritis (joints)
==Related Chapters==
:::* Preferred regimen: [[Penicillin G]] IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
* [[Streptobacillus moniliformis]]
 
* [[Spirillum minus]]
::* (2) Diarrhea, especially kids. Liver or spleen abscess (gastrointestinal)
:::* Preferred regimen: [[Penicillin G]] IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (3) Undifferentiated fever
:::* Preferred regimen: [[Penicillin G]] IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (4) Endocarditis, myocarditis, pericarditis (cardiac)
:::* Preferred regimen: [[Penicillin]] 20 mU/day IV divided q4h. Optimal duration recommendation for IE is 4 wks.
:::* Alternative regimen: [[Cephalosporins]]-[[Ceftriaxone]] {{or}} [[Clindamycin]] {{or}} [[Erythromycin]] {{or}} [[Chloramphenicol]] {{and}} [[Streptomycin]].
 
::* (5) Meningitis, brain abscess
:::* Preferred regimen: [[Penicillin]] 20 mU/day IV divided q4h. Optimal duration recommendation for IE is 4 wks.
:::* Alternative regimen: [[Cephalosporins]]-[[Ceftriaxone]] {{or}} [[Clindamycin]] {{or}} [[Erythromycin]] {{or}} [[Chloramphenicol]] {{and}} [[Streptomycin]].
 
::* (6) Anemia
:::* Preferred regimen: [[Penicillin G]] IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (7) Pneumonia
:::* Preferred regimen: [[Penicillin G]] IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (8) Amnionitis (pregnancy)
:::* Preferred regimen: [[Penicillin G]] IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (9) Renal abscess
:::* Preferred regimen: [[Penicillin G]] IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
==External Links==
*[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5351a2.htm Case report of fatal incidence in the USA]
*http://www.cdc.gov/rat-bite-fever/
 
{{Bacterial diseases}}
[[hr:Vrućica štakorskog ugriza]]
[[it:febbri da morso di ratto]]
[[ja:鼠咬症]]


[[Category:Disease]]
[[Category:Disease]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Infectious diseases]]
[[Category:Infectious diseases]]
[[Category:Overview complete]]
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Latest revision as of 19:21, 6 August 2015

This page is about clinical aspects of the disease. For microbiologic aspects of specific causative organisms: Template:Seealso Template:Seealso

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Spirillum minus rat bite fever; spirochaeta morsus minus; spirochaeta muris; sokosho; sodoku.

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