Rat-bite fever

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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.

Overview

Historical Perspective

Pathophysiology

Epidemiology and Demographics

Risk Factors

Causes

Differentiating Rat-bite fever from other Diseases

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Prevention | Cost-effectiveness of Therapy | Future or Investigational Therapies

  • (1) Migratory arthropathy and arthritis (joints)
  • 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.


  • (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)
  • (5) Meningitis, brain abscess
  • (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.

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