Streptobacillus moniliformis rat-bite fever
There are 2 types of rat-bite fever: streptobacillary (caused by Streptobacillus moniliformis, a gram-negative bacillus) and spirillary rat-bite fever (caused by Spirillum minus). Streptobacillary rat-bite fever, also known as Haverhill fever or epidemic arthritic erythema, is the type of rat-bite fever usually seen in the United States and also seen worldwide. After an incubation period of around a week, there is acute onset of fever, chills, headache, nausea, vomiting, severe migratory myalgias and arthralgias, and frequently arthritis (most commonly in the knees). In cases that occur after ingestion, vomiting and pharyngitis are more prominent. A rash accompanies the acute illness.
If untreated, potential complications of both forms of rat-bite fever may include meningitis, endocarditis, pericarditis, pneumonitis, anemia, amnionitis, prostatitis, pancreatitis, and abscesses in various organs.
A25.1 – Streptobacillosis
52138004 – Streptobacillary fever
Differential Diagnosis & Pitfalls
- Spirillary rat-bite fever
- Staphylococcus aureus sepsis (see bacterial sepsis)
- Streptococcus pyogenes sepsis (see bacterial sepsis)
- Scarlet fever
- Lyme disease
- Secondary syphilis
- Rocky Mountain spotted fever
- Viral exanthem
- Still disease
- Serum sickness-like eruption