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Rat bite fever without fever

¹ Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland
² Department of Microbiology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland

Correspondence to:
Correspondence to:
Dr J Dudler, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland;
jdudler{at}chuv.hospvd.ch

ABSTRACT
Rat bite fever is a rarely reported acute febrile bacterial illness caused by Streptobacillus moniliformis or Spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. Diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.

Keywords: Streptobacillus moniliformis; infectious arthritis; rat bite fever

Abbreviations: MCP, metacarpophalangeal; NSAIDs, non-steroidal anti-inflammatory drugs

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