Rat bite disease

Place 1926.

Erythema arthriticum epidemicum, Haverhill fever, bacterial rat-bite disease, sodocu.

Infection caused by Streptobacillus moniliformis, a gram-negative, pleomorphic bacillus.

• Rare disease in Central Europe.
• More common in Asia.

• Triggers are a rat bite or contaminated food.
• Pathogen: Streptobacillus moniliformis or Spirillum minus (spiral rat bite fever).
• Incubation period: 1-5 days.

• Reduced general condition, febrile temperatures, chills, cephalgias, myalgias and gastrointestinal symptoms.
• After up to 3 days, there is the appearance of maculopapular exanthema on the extremities and palmoplantar. Petechiae may also be seen.

• Travel history.
• Clinical.
• Blood cultures.
• CAVE: Lues serology can be false-positive.

Endocarditis.

• Retreatment external therapy.
• PenicillinG i.v. 4 million IU 6x tgl.
• Alternative: Erythromycin p.o. 500 mg 3x tgl, maximum dose: 4 g/d (adults), 40-100 mg/kg
• Alternative: Streptomycin i.m. 1 g 1x tgl

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