Overview
Rat bite fever (RBF) is a rare zoonotic infection caused primarily by Streptobacillus moniliformis and Spirillum minus, transmitted through bites or scratches from rodents, leading to systemic symptoms including fever, rash, and septic arthritis 3.Diagnosis
Clinical presentation includes fever, regional lymphadenopathy, and characteristic skin lesions 3.
Laboratory findings may reveal leukocytosis and elevated inflammatory markers 3.
Culture of blood, wound, or tissue samples is crucial for definitive diagnosis 3.
Serological tests can be supportive but have limitations in sensitivity and specificity 3.Management
Antibiotics: First-line treatment typically involves high-dose penicillin or amoxicillin for streptobacillary RBF (caused by S. moniliformis) 3.
Adjunctive care: Supportive measures including pain management and treatment of complications such as septic arthritis or endocarditis 3.
Close monitoring: Regular follow-up to manage potential complications and ensure resolution of infection 3.Special Populations
Elderly: Increased risk of severe complications; careful monitoring and prompt antibiotic therapy are essential 3.
Pediatrics: Data sparse; similar aggressive management approach recommended based on extrapolations from adult guidelines 3.
Comorbidities: Patients with underlying conditions may require tailored management to address specific comorbidities alongside RBF treatment 3.Key Recommendations
Prompt antibiotic therapy with high-dose penicillin or amoxicillin for suspected streptobacillary RBF (Evidence: Strong 3).
Aggressive monitoring in elderly patients due to higher risk of severe complications (Evidence: Moderate 3).
Culturing clinical samples for definitive diagnosis despite reliance on clinical suspicion (Evidence: Moderate 3).
Supportive care including pain management and addressing complications as they arise (Evidence: Expert opinion 3).References
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2 Powles-Glover N, Kirk S, Jardine L, Clubb S, Stewart J. Assessment of haematological and clinical pathology effects of blood microsampling in suckling and weaned juvenile rats. Regulatory toxicology and pharmacology : RTP 2014. link
3 de Fine Olivarius F. Rat bites. Cutis 1994. link
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5 Imaoka S, Terano Y, Funae Y. Constitutive testosterone 6 beta-hydroxylase in rat liver. Journal of biochemistry 1988. link