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Rat-bite fever
Definition:
Rat-bite fever is an infectious disease transmitted in the secretions of the mouth or nose or the urine of an infected rodent.

Alternative Names:
Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic erythema; Spirillary fever; Sodoku

Causes, incidence, and risk factors:

Rat-bite fever can be caused by two different organisms, Streptobacillusmoniliformis and Spirillum minus. It is rare in North and South America.

Most people acquire rat-bite fever through contact with urine or oral (mouth) or conjunctival (eye or nose) secretions from an infected animal. This most commonly occurs via a bite, yet some cases may occur simply through contact with these secretions. The source of the infection is usually a rat, but other animals such as squirrels, weasels, and gerbils, may be the source.

In rat-bite fever due to Streptobacillus moniliformis, fever, chills, headache, and muscle pain usually occur within 10 days of exposure. This is followed within three days by a diffuse rash, primarily in the extremities. One or several large joints may become swollen, red, and painful. If untreated, severe complications including infection of the heart valves may occur.

The illness caused by Spirillum minus is common in Asia, particularly Japan, where it is called sodoku. In this form of rat-bite fever, a particular skin rash characterized by red or purple plaques is frequently seen, and the previously healed wound at the site of the bite may reactivate and open. Joint involvement is rare.
Symptoms:
  • Fever
  • Chills
  • Headache
  • Muscle aches
  • Rash -- may be red/purple plaques in sodoku
  • Arthritis (singe or multiple large joints) -- less common in sodoku
  • Open sore at the site of initial bite in sodoku
Signs and tests:
Diagnosis is made by detection of the organism in skin, blood, joint fluid, or lymph nodes. Blood antibody tests may also be used.
Treatment:
Rat-bite fever is usually treated with antibiotic therapy. Your health care provider may prescribe penicillin or tetracyclines for 7-10 days.
Expectations (prognosis):
The prognosis is excellent with early treatment.
Complications:
Calling your health care provider:
Call your health care provider if you or your child has had recent contact with a rat or other rodents, particularly if the person was bitten or has symptoms of rat-bite fever.
Prevention:
Avoiding contact with rats or rat-contaminated dwellings may help prevent rat-bite fever. A course of oral antibiotics following a rat bite may also help prevent this illness.
Review Date: 12/24/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
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