J Korean Rheum Assoc.  2007 Sep;14(3):285-290. 10.4078/jkra.2007.14.3.285.

A Case of Rat Bite Fever Arthritis

• Choi GS
• Kang JK
• Soe KW
• Park HJ
• Kim HA
• Park HS
• Suh CH

• KMID: 2202180
• DOI: http://doi.org/10.4078/jkra.2007.14.3.285

Abstract

Rat bite fever is a rare, systemic illness caused by Streptobacillus moniliformis or Spirillum minus following a rat or other rodent bite. Characteristically, fever develops abruptly with maculopapular skin rash after an incubation period of two to ten days, and asymmetric migrating polyarthritis starts later in up to 50% of patients. The arthritis involves the knees, shoulders, elbows, wrists and hands, which may either be suppurative or non-suppurative. Although most cases seem to resolve spontaneously within two weeks, the mortality in untreated cases is around 10~15%. The response to antibiotic treatment is good and early diagnosis is the most important prognostic factor. We report a patient who developed arthritis with fever after biting by rat.

Keyword

Rat bite fever; Arthritis

MeSH Terms

Animals
Arthritis*
Early Diagnosis
Elbow
Exanthema
Fever
Hand
Humans
Knee
Moniliformis
Mortality
Rat-Bite Fever*
Rats*
Rodentia
Shoulder
Spirillum
Streptobacillus
Wrist

Figure

• 

  Fig. 1. The picture shows arthritis of the right ankle and midtarsal joint with the site of the rat bite (arrow), which had healed.

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  Fig. 2. The picture shows osteoarthritic change at both 2~5th proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint with amputated right third distal phalanx in the hand x-ray, but no juxta- articular erosions and periarticular osteopenia in all of simple hand, foot, knee x-ray.

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  Fig. 3. Whole body bone scan shows arthritic change at right shoulder joint, right wrist and second metacarphphalangeal joint (MCP), left third distal interphalangeal (DIP) joint and both ankle joint.

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