rat-bite fever
American Heritage Dictionary:
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rat-bite fever
(răt'bīt')
n.
Either of two infectious diseases contractible from the bite of a rat, specifically:
n.
Either of two infectious diseases contractible from the bite of a rat, specifically:
- A disease caused by the bacterium Streptobacillus moniliformis and characterized by skin inflammation, back and joint pains, headache, and vomiting.
- A disease caused by the bacterium Spirillum minus and characterized by ulceration at the site of the bite, a purplish rash, and recurrent fever.
Gale Encyclopedia of Children's Health:
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Rat-Bite Fever
Definition
Rat-bite fever refers to an infection which develops in a person after being bitten or scratched by an infected animal.
Description
Rat-bite fever occurs most often among laboratory workers who handle lab rats in their jobs, and among people who live in poor conditions, with rodent infestation. Children are particularly likely to be bitten by rodents infesting their home and are, therefore, most likely to contract rat-bite fever. Other animals that can carry the types of bacteria responsible for this illness are mice, squirrels, weasels, dogs, and cats. One kind of bacteria can cause the same illness if it is ingested in unpasteurized milk or in water that has been contaminated with rat waste.
Demographics
About half of all cases of rat-bite fever occur in children.
Causes and Symptoms
There are two variations of rat-bite fever, caused by two different organisms. In the United States, the bacteria Streptobacillus moniliformis is the most common cause (causing streptobacillary rat-bite fever). In other countries, especially Africa, Spirillum minus causes a different form of the infection (called spirillary rat-bite fever).
Streptobacillary rat-bite fever occurs up to 22 days after the initial bite or scratch. The patient becomes ill with fever, chills, nausea and vomiting, headache, and pain in the back and joints. A rash made up of tiny pink bumps develops, covering the palms of the hands and the soles of the feet. Without treatment, the patient is at risk of developing serious infections of the lining of the heart (endocarditis), the sac containing the heart (pericarditis), the coverings of the brain and spinal cord (meningitis), or lungs (pneumonia). Any tissue or organ throughout the body may develop a pocket of infection and pus, called an abscess.
Spirillary rat-bite fever occurs some time after the initial injury has already healed, up to about 28 days after the bite or scratch. Although the wound had appeared completely healed, it suddenly grows red and swollen again. Lymph nodes in the area become swollen and tender, and the patient develops fever, chills, and headache. The skin in the area of the original wound sloughs off. Although rash is less common than with streptobacillary rat-bite fever, there may be a lightly rosy, itchy rash all over the body. Joint and muscle pain rarely occur. If left untreated, the fever usually subsides, only to return again in repeated two- to four-day cycles. Though these cycles can last for a year, the illness usually resolves without treatment in four to eight weeks. This can go on for up to a year although, even without treatment, the illness usually resolves within four to eight weeks.
Diagnosis
In streptobacillary rat-bite fever diagnosis can be made by taking a sample of blood or fluid from a painful joint, which can be cultured to allow the growth of organisms. Examination under a microscope will then allow identification of the bacteria Streptobacillus moniliformis.
In spirillary rat-bite fever, diagnosis can be made by examining blood or a sample of tissue from the wound for evidence of Spirillum minus.
Treatment
Either injections of procaine penicillin G or penicillin V by mouth are effective against both streptobacillary and spirillary rat-bite fever. When a patient is allergic to the penicillins, either erythromycin may be given by mouth for streptobacillary infection or tetracycline by mouth for spirillary infection.
Prognosis
With treatment, prognosis is excellent for both types of rat-bite fever. Without treatment, the spirillary form usually resolves on its own, although it may take up to a year to do so.
The streptobacillary form, found in the United States, however, can progress to cause extremely serious, potentially fatal complications. In fact, before antibiotics were available to treat the infection, streptobacillary rat-bite fever frequently resulted in death.
Prevention
Prevention involves avoiding contact with those animals capable of passing on the causative organisms. This can be a difficult task for people whose economic situations do not allow them to move out of rat-infested buildings. Because streptobacillary rat-bite fever can occur after drinking contaminated milk or water, only pasteurized milk, and water from safe sources, should be ingested.
Parental Concerns
The parents of children living in rodent-infested conditions, or who have pet rodents (mice, rats, gerbils) should be vigilant to illness in their children.
Resources
Books
Barnett, S. Anthony. The Story of Rats: Their Impact on Us and Our Impact on Them. Crows Nest, New South Wales, Australia: Allen & Unwin, Pty., Limited, 2002.
Conniff, Richard. Rats: The Good, the Bad, and the Ugly. New York: Random House Children's Books, 2002.
Sullivan, Robert. Rats: Observation on the History and Habitat of the City's Most Unwanted Inhabitant. London: Bloomsbury Publishing, 2005.
Organizations
Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. Web site: www.cdc.gov.
Web Sites
"Rat-bite fever." MedlinePlus. Available online at www.nlm.nih.gov/medlineplus/ency/article/001348.htm (accessed December 29, 2004).
[Article by: Rosalyn Carson-DeWitt, MD]
American Heritage Stedman's Medical Dictionary:
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rat-bite fever
n.
Headache, fever, lymphangitis, and lymphadenitis following the bite of a rat or other rodent, due either to a spirillum or to Streptobacillus moniliformis.
Wikipedia on Answers.com:
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Rat-bite fever
| Rat-bite fever | |
|---|---|
| Classification and external resources | |
| ICD-10 | A25 |
| ICD-9 | 026 |
| DiseasesDB | 32803 30717 |
| MeSH | D011906 |
Rat-bite fever is an acute, febrile human illness caused by bacteria transmitted by rodents, rats in most cases, which is passed from rodent to human via the rodent's urine or mucous secretions. Alternative names for rat bite fever include streptobacillary fever, streptobacillosis, spirillary fever, sodoku, and epidemic arthritic erythema. It is a rare disease spread by infected rodents and can be caused by two specific types of bacteria. Most cases occur in Japan, but specific strains of the disease are present in the United States, Europe, Australia, and Africa. Some cases are diagnosed after patients were exposed to the urine or bodily secretions of an infected animal. These secretions can come from the mouth, nose, or eyes of the rodent. The majority of cases are due to the animal's bite. It can also be transmitted throughout food or water that is contaminated with rat feces or urine. Rats are not the only type of animal that can be infected with this disease. Others include weasels, gerbils, and squirrels. Household pets such as dogs or cats that are exposed to these animals can also carry the disease and infect humans. If a person is bitten by a rodent, it is important to quickly wash and cleanse the wound area thoroughly with antiseptic solution to reduce the risk of infection.
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Contents
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Causes
Two types of gram-negative facultatively anaerobic bacteria can cause the infection.
Spirillosis
Main article: Sodoku
Rat-bite fever transmitted by the gram-negative spirochaete Spirillum minus is more rare, and is found most often in Asia. In Japan the disease is called Sodoku. Symptoms do not manifest for two to four weeks after exposure to the organism, and the wound through which it entered exhibits slow healing and marked inflammation. The fever lasts longer and is recurring, for months in some cases. Rectum pain and gastrointestinal symptoms are less severe or are absent. Penicillin is the most common treatment.
Streptobacillosis
Main article: Haverhill fever
The Streptobacillosis form of rat-bite fever is known by the alternative names Haverhill Fever and epidemic arthritic erythema. It is a severe disease caused by Streptobacillus moniliformis, transmitted either by rat bite or ingestion of contaminated products (Haverhill fever). After an incubation period of 2-10 days, Haverhill fever begins with high prostrating fevers, rigors, headache and polyarthralgia. Soon an exanthem appears, either maculopapular or petechial and arthritis of large joints can be seen. The organism can be cultivated in blood or articular fluid. The disease can be fatal if untreated in 20% of cases due to malignant endocarditis, meningoencephalitis or septic shock. Treatment is with penicillin or tetracycline.
Symptoms
Symptoms will be different for every person and will be different depending on the type of rat bite fever that a person is infected with. Both spirillary rat bite fever and streptobacillary rat bite fever have a few individual symptoms although most symptoms are crossovers. Streptobacillary is most commonly found in the United States and spirillary rat bite fever is generally diagnosed in patients in Africa and other countries. Rat bite symptoms are visually seen in most cases and include inflammation around the open sore. A rash can also spread around the area and appear red or purple.[1] Other symptoms associated with streptobacillary rat bite fever include chills, fever, vomiting, headaches, and muscle aches. Joints can also become painfully swollen and pain can be experienced in the back. Along with rash and swollen joints, skin irritations like ulcers or inflammation can develop on the hands and feet. Wounds will heal slowly, so it is possible that symptoms will come and go over the course of a few months. It is important to contact a physician and report these symptoms immediately.
Symptoms associated with spirillary rat bite fever include issues with the lymph nodes. The lymph nodes which lie in the lymphatic system will often swell or inflame as a reaction to the disease or infection. The most common locations of lymph node swelling are in the neck, groin and underarm.[2] Symptoms generally appear within two to ten days of exposure to the affected animal. It will begin with the fever and will progress to the rash that will appear on the hands and feet within two to four days. Rash will appear all over the body with this form of the infection and will rarely cause symptoms of joint pain.
Test and diagnosis
This condition is diagnosed by detecting the bacteria in skin, blood, joint fluid, or lymph nodes. Blood antibody tests may also be used.[3] To get a proper diagnosis for rat bite fever, different tests are run depending on the type of symptoms that are being experienced.
To diagnosis streptobacillary rat bite fever, blood or joint fluid is extracted and the organisms living in it are cultured. Diagnosis for spirillary rat bite fever is by direct visualization or culture of spirillum from blood smears or tissue from lesions or lymph nodes.[4] Treatment of antibiotics is the same for both types of infection.
Treatment
Responds to penicillin antibiotics or where allergic to this erythromycin or tetracyclines for respectively streptobacillary or spirillary infections.
Prevention
Whilst obviously preventable by staying away from rodents, otherwise hands and face should be washed after contact and any scratches both cleaned and antiseptics applied.
Prognosis
When proper treatment is provided for patients with rat bite fever, the prognosis is positive. Without treatment, the infection usually resolves on its own, although it may take up to a year to do so.[5] A particular strain of rat bite fever that is located in the United States can progress and cause serious complications that can be potentially fatal. Before antibiotics were used for the treatment of rat bite fever, many cases resulted in death. If left untreated, streptobacillary can result in infection in the lining of the heart, covering over the spinal cord and brain, or in the lungs. Any tissue or organ throughout the body may develop a pocket of infection and pus, called an abscess.[6]
See also
References
- ^ Rat Bite Fever Retrieved on 2010-01-26
- ^ Swollen Lymph Nodes Wrong Diagnosis Portal. Retrieved on 2010-01-26
- ^ MedlinePlus Encyclopedia Rat-bite fever
- ^ Rat Bite Fever Spirochetes at Merck Manual of Diagnosis and Therapy Professional Edition
- ^ Rat Bite Fever Overview Medical Dictionary Portal. Retrieved on 2010-01-26
- ^ Rat Bite Fever Description Encyclopedia of children's health. Retrieved on 2010-01-26
External links
- "Fatal rat-bite fever—Florida and Washington, 2003". MMWR Morb. Mortal. Wkly. Rep. 53 (51): 1198–202. January 2005. PMID 15635289. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5351a2.htm.
- Rat-bite fever (healthAtoZ.com)
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American Heritage Dictionary
The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.
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Gale Encyclopedia of Children's Health
© 2006 by The Gale Group, Inc. All rights reserved.
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American Heritage Stedman's Medical Dictionary
The American Heritage® Stedman's Medical Dictionary Copyright © 2002, 2001, 1995 by Houghton Mifflin Company.
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