Rat bite disease A25.90

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

advice bit fever; Bacterial Rat Bite Disease; Erythema arthriticum epidemicum; Haverhill fever; Haverhill Fever; Sodoku

History
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Place 1926

Definition
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Notifiable (about 50% of all rats are affected), rare bacterial infectious disease transmitted to humans through bite wounds or contaminated food. More frequent and more severe form of rat bite fever.

Pathogen
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Streptobacillus moniliformis or Spirillum minus (spiral rat bite fever).

Occurrence/Epidemiology
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In Asia often, in Europe rarely.

Clinical features
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General: Incubation period 1-5 days. Fever, chills, headache, myalgia, polyarthralgia.

Skin lesions: 2-3 days after clinical manifestation morbilliform, maculopapular exanthema, petechiae, especially on extremities, palmae and plantae.

Diagnosis
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Blood culture.

Differential diagnosis
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Meningococcal sepsis; gonococcal sepsis; different virus exanthema; Rocky Mountains spotted fever.

External therapy
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Symptomatic therapy e.g. with lotio alba.

Internal therapy
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Systemic antibiotic therapy with benzylpenicillin (e.g. Penicillin Grünenthal 1 Mega) 2 times 0.6 million IU/day i.v. over 10-14 days, in case of complications such as endocarditis 5-20 million IU/day i.v. over 28 days.

Alternatively for penicillin allergy: Erythromycin (e.g. Erythrocin 500 Neo Filmtbl.) 2 g/day p.o. in 2-4 ED or Streptomycin 1 g/day i.m. (e.g. streptomycin fatol).

Literature
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  1. Hryciw BN et al (2018) Council bite fever on Vancouver Island: 2010-2016
    .Can Commun Dis Rep 44:215-219.
  2. Prouty M (1950) Periarteritis nodosa associated with ratbite fever due to streptobacillus moniliformis (erythema arthriticum epidemicum). J Pediatr 36:605-613.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020