Rat-bite fever
| Rat-bite fever | |
|---|---|
| Classification and external resources | |
| Specialty | infectious disease |
| ICD-10 | A25 |
| ICD-9-CM | 026 |
| DiseasesDB | 32803 30717 |
| MedlinePlus | 001348 |
| MeSH | D011906 |
Rat-bite fever is an acute, febrile human illness caused by bacteria transmitted by rodents, rats, or mice, in most cases, which is passed from rodent to human by the rodent's urine or mucous secretions. Alternative names for rat-bite fever include streptobacillary fever, streptobacillosis, spirillary fever, sodoku, and epidemic arthritic erythema. It is a rare disease spread by infected rodents and can be caused by two specific types of bacteria. Most cases occur in Japan, but specific strains of the disease are present in the United States, Europe, Australia, and Africa. Some cases are diagnosed after patients were exposed to the urine or bodily secretions of an infected animal. These secretions can come from the mouth, nose, or eyes of the rodent. The majority of cases are due to the animal's bite. It can also be transmitted throughout food or water contaminated with rat feces or urine. Other animals can be infected with this disease, including weasels, gerbils, and squirrels. Household pets such as dogs or cats exposed to these animals can also carry the disease and infect humans. If a person is bitten by a rodent, it is important to quickly wash and cleanse the wound area thoroughly with antiseptic solution to reduce the risk of infection.
Two types of Gram-negative, facultatively anaerobic bacteria can cause the infection.
Rat-bite fever transmitted by the Gram-negative coiled rod Spirillum minus (also known as Spirillum minor) is more rare, and is found most often in Asia. In Japan, the disease is called sodoku. Symptoms do not manifest for two to four weeks after exposure to the organism, and the wound through which it entered exhibits slow healing and marked inflammation. The fever lasts longer and is recurring, for months in some cases. Rectal pain and gastrointestinal symptoms are less severe or are absent. Penicillin is the most common treatment.
The streptobacillosis form of rat-bite fever is known by the alternative names Haverhill fever and epidemic arthritic erythema. It is a severe disease caused by Streptobacillus moniliformis, transmitted either by rat bite or ingestion of contaminated products (Haverhill fever). After an incubation period of 2–10 days, Haverhill fever begins with high prostrating fevers, rigors (shivering), headache, and polyarthralgia (joint pain). Soon, an exanthem (widespread rash) appears, either maculopapular (flat red with bumps) or petechial (red or purple spots) and arthritis of large joints can be seen. The organism can be cultivated in blood or articular fluid. The disease can be fatal if untreated in 20% of cases due to malignant endocarditis, meningoencephalitis, or septic shock. Treatment is with penicillin, tetracycline, or doxycycline.
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