Rat-bite fever
| Rat-bite fever | |
| ICD-10 | A25 |
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| ICD-9 | 026 |
| DiseasesDB | 32803 Template:DiseasesDB2 |
| MeSH | D011906 |
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Rat-bite fever Microchapters |
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Diagnosis |
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Rat-bite fever On the Web |
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American Roentgen Ray Society Images of Rat-bite fever |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Pathophysiology
Epidemiology & Demographics
Risk Factors
Screening
Causes
Differentiating Rat-bite fever
Complications & Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics
Treatment
Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies
Risk Factors
Persons who are at risk for infection include those who work with animals in labs or pet stores and persons living in dwellings infested with wild rats. People who have pet rats may also be at risk for infection.
Symptoms
Initial symptoms are non-specific and include fever, chills, myalgias, arthralgias, headache, vomiting. Patients may develop a maculopapular rash on the extremities or septic arthritis 2-4 days after fever onset. The incubation period typically ranges from 2-10 days. If not appropriately treated, severe manifestations may include endocarditis, myocarditis, meningitis, pneumonia and sepsis. In rare cases, death occurs.
Diagnosis
The findings of rash, fever, and arthritis in individuals with a history of rat exposure suggest the diagnosis of Rat-bite fever.
Diagnosis of S. moniliformis is typically made by isolating the organism from blood or synovial fluid. Specific media and incubation conditions should be used. In the absence of a positive culture, identification of pleomorphic gram-negative bacilli in appropriate specimens supports a preliminary diagnosis. Since the organism does not grow in artificial media, diagnosis of S. minus is made by identifying characteristic spirochetes in appropriate specimens using darkfield microscopy or differential stains.
Risk Stratification and Prognosis
Severe complications such as endocarditis, myocarditis, pericarditis, pneumonia, meningitis, and focal organ abscesses may occur. Rapidly fatal cases have been reported. Untreated RBF is associated with a mortality of 7%-10%. With appropriate antimicrobial therapy, the clinical course may be shortened and severe complications may be prevented.
Treatment
Responds to penicillin antibiotics or where allergic to this erythromycin or tetracyclines for repectively streptobacillary or spirillary infections.
Prevention
Whilst obviously preventable by staying away from rodents, otherwise hands and face should be washed after contact and any scratches both cleaned and antiseptics applied.
References
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/ratbitefever_g.htm
External links
- Rat-bite fever description
- Case report of fatal incidence in the USA
- Rat-bite fever (healthAtoZ.com)
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