Streptobacillaire rattenbeetziekte: casus en literatuurbespreking

Abstract

Streptobacillary rat-bite fever: case report and literature review Streptobacillary rat-bite fever (RBF) is a rare multisystem infectious disease caused by Streptobacillus moniliformis and is transmitted by rat bites or through direct contact with rat excretions. Symptoms can include fever, polyarthralgia or polyarthritis and a polymorphic rash. A 48-year-old woman with fibromyalgia was admitted to the hospital with a 3-week history of fever and asymmetric oligoarthritis. S. moniliformis was isolated from blood cultures and the diagnosis of RBF was confirmed by a targeted anamnesis, which revealed a rat bite. After 7 days in hospital with benzylpenicillin treatment (IV), she was discharged to complete a 5-week course of oral amoxicillin at home. Her symptoms almost completely resolved. This case illustrates the diagnostic and clinical difficulties microbiologists and clinicians face in a case of RBF. A thorough history-taking by clinicians and extensive microbiological investigations can be helpful for an early diagnosis and a correct treatment of streptobacillary RBF, preventing morbidity and mortality.