A 10yo boy obtained a pet rat from a commercial pet store. Upon returning home, his new pet promptly bit him. 5 days later, he has fever, chills, severe headache, polyarthralgias, and a maculopapular rash with some petechiae that developed after 2 days of fever. What organism is the most likely cause for the boy’s symptoms?
A. Staphylococcus aureus
B. Group A Streptococcus pyogenes
C. Eikenella corrodens
D. Rabies virus
E. Streptobacillus moniliformus
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July 6, 2017 at 1:53 am
E. Streptobacillus moniliformus
The patient is suffering from rat-bite fever, caused by Streptobacillus moniliformus or, more often in Asia, Spirillum minus. Symptoms occur 3-10 days (up to 3 weeks) after contact with an infected rodent, and any bite may be healed by the time of presentation. Rash occurs within 2-4 days after fever. Before the rash, the patient is often misdiagnosed as flu-like illness. The infection can be fatal, and should be treated ASAP with penicillin or doxycycline. A boy did die recently from this scenario http://www.sandiegouniontribune.com/news/courts/sd-me-rat-verdict-20170420-story.html Staph and strep cause skin and soft tissue infections such as abscesses and cellulitis. Eikenella is associated with human bite infections. Rats are not a high risk animal for rabies transmission.