Rat-bite fever
Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic erythema; Spirillary fever; Sodoku
Rat-bite fever is a rare bacterial disease spread by the bite of an infected rodent.
Causes
Rat-bite fever can be caused by either of two different bacteria, Streptobacillus moniliformis or Spirillum minus. Both of these are found in the mouths of rodents.
The disease is most often seen in:
- Asia
- Europe
- North America
Most people get rat-bite fever through contact with urine or fluids from the mouth, eye, or nose of an infected animal. This most commonly occurs through a bite or scratch. Some cases may occur simply through contact with these fluids.
A rat is usually the source of the infection. Other animals that may cause this infection include:
- Gerbils
- Squirrels
- Weasels
Symptoms
Symptoms depend on the bacteria that caused the infection.
Symptoms due to Streptobacillus moniliformis may include:
- Chills
- Fever
- Joint pain, redness, or swelling
- Rash
Symptoms due to Spirillum minus may include:
- Chills
- Fever
- Open sore at the site of the bite
- Rash with red or purple patches and bumps
- Swollen lymph nodes near the bite
Symptoms from either organism usually resolve within 2 weeks. Untreated, the symptoms, such as fever or joint pain, can keep returning for many weeks or longer.
Exams and Tests
The health care provider will perform a physical examination and ask about your symptoms. If the provider suspects rat bite fever, tests will be done to detect the bacteria in:
- Skin
- Blood
- Joint fluid
- Lymph nodes
Blood antibody tests and other techniques may also be used.
Treatment
Rat-bite fever is treated with antibiotics (typically oral) for 7 to 14 days.
Outlook (Prognosis)
The outlook is excellent with early treatment. If it is not treated, the death rate can be as high as 25%.
Possible Complications
Rat-bite fever may cause these complications:
- Abscesses of the brain or soft tissue
- Infection of the heart valves
- Inflammation of the parotid (salivary) glands
- Inflammation of the tendons
- Inflammation of the heart lining
When to Contact a Medical Professional
Contact your provider if:
- You or your child has had recent contact with a rat or other rodent
- The person who was bitten has symptoms of rat-bite fever
Prevention
Avoiding contact with rats or rat-contaminated dwellings may help prevent rat-bite fever. Taking antibiotics by mouth promptly after a rat bite may also help prevent this illness.
References
Mekala V, Washburn RG. Rat-bite fever: Streptobacillus moniliformis and Spirillum minus. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 231.
Shandro JR, Jauregui JM. Wilderness-acquired zoonoses. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 34.
Vyas JM. Rat-bite fever. In: Kellerman RD, Rakel D, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier; 2023:670-672.
Version Info
Last reviewed on: 12/4/2022
Reviewed by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
