RESUMEN
BACKGROUND: Worldwide, disease in children due to exposure to rats is increasing, also in the Netherlands. Not only the generally known pathogen Leptospira should be considered, also S. moniliformis, Yersinia pestis, Lymphocytic choriomeningitis virus, Hantavirus, Francisella tularensis and Pasteurella multocida are also known rat-associated zoonosis. CASE DESCRIPTION: An 12-year-old boy visited the pediatrician with fever, headache and nausea, followed by generalized erythema and arthritis. The boy had a pet rat. The patient's blood culture was positive for S. moniliformis. The patient was treated with antibiotics and made a full recovery. CONCLUSION: Just like many rat-associated diseases have 'rat-bite fever' caused by S. moniliformis an nonspecific clinical presentation. It is not necessary to have had a rat bite, to develop rat-bite fever. Better awareness and knowledge about rat related diseases should contribute to earlier diagnosis and treatment. Which is of great importance because of increased morbidity and mortality associated to rat related diseases.
Asunto(s)
Antibacterianos , Fiebre por Mordedura de Rata , Niño , Masculino , Humanos , Fiebre por Mordedura de Rata/diagnóstico , Fiebre por Mordedura de Rata/tratamiento farmacológico , Animales , Antibacterianos/uso terapéutico , Ratas , Resultado del Tratamiento , Streptobacillus/aislamiento & purificación , Zoonosis/diagnósticoRESUMEN
BACKGROUND: Rat bite fever is a rare but potentially fatal bacterial zoonosis. The symptoms can be unspecific, but severe sepsis can be associated with involvement of different organs. CASE REPORT: A 27-year-old homeless man presented with fever, suspected meningitis, acute renal failure, unclear skin lesions as well as joint problems and muscular pain. Bite wounds were not detected. Meningitis could be excluded after lumbar puncture, and there was no evidence of endocarditis as the cause of the skin lesions. After 72â¯h, growth of Streptobacillus moniliformis in blood cultures was detected. Clinical symptoms were compatible with the diagnosis of rat bite fever. Calculated antibiosis with ampicillin sulbactam and doxycycline led to regression of the symptoms. CONCLUSION: Rat bite fever poses a diagnostic challenge due unspecific symptoms, diverse differential diagnostic options, and challenging microbiological detection. Patient history is of the utmost importance. Due to the rarity of the disease, this case report is intended to raise awareness.
Asunto(s)
Fiebre por Mordedura de Rata , Streptobacillus , Zoonosis , Masculino , Adulto , Fiebre por Mordedura de Rata/diagnóstico , Fiebre por Mordedura de Rata/tratamiento farmacológico , Fiebre por Mordedura de Rata/microbiología , Humanos , Animales , Streptobacillus/aislamiento & purificación , Zoonosis/diagnóstico , Zoonosis/microbiología , Zoonosis/transmisión , Antibacterianos/uso terapéutico , Doxiciclina/uso terapéutico , Diagnóstico Diferencial , Ratas , Sulbactam/uso terapéutico , Sulbactam/administración & dosificación , Ampicilina/uso terapéuticoRESUMEN
BACKGROUND: Rat bite fever (RBF) is a rare systemic febrile illness transmitted by rats. Streptobacillus moniliformis is a pleomorphic Gram-negative bacillus which is the usual etiologic organism for rat bite fever in the United States. CASE PRESENTATION: Here we present a case of rat bite fever complicated by vertebral osteomyelitis and discitis. The patient revealed an exposure history of being bitten by pet rats. The patient's symptoms dramatically improved with a six-week course of cephalexin therapy. CONCLUSIONS: It is important to obtain a thorough zoonotic exposure history and maintain rat bite fever in the differential when considering potential causes of discitis and osteomyelitis.
Asunto(s)
Discitis/etiología , Osteomielitis/etiología , Fiebre por Mordedura de Rata/complicaciones , Animales , Animales Domésticos , Antibacterianos/administración & dosificación , Mordeduras y Picaduras/complicaciones , Cefalexina/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Fiebre por Mordedura de Rata/diagnóstico , Fiebre por Mordedura de Rata/tratamiento farmacológico , Ratas , Streptobacillus/efectos de los fármacos , Streptobacillus/aislamiento & purificación , Resultado del TratamientoRESUMEN
Rat bite fever (RBF) caused by Streptobacillus moniliformis has been described as a diagnostic challenge. While it has a favorable prognosis with treatment, timely diagnosis is hindered by the lack of culture-free identification methods. Here we present a multiplex real-time PCR assay that detects the zoonotic Streptobacillus spp. as well as differentiate the primary causative agent of RBF, Streptobacillus moniliformis. The performance of this assay was evaluated using mock clinical specimens for blood, serum, and urine. Analytical sensitivity was determined to be 3-4 genome equivalents (GE)/µl for the zoonotic Streptobacillus spp. target, and 1-2 GE/µl for the S. moniliformis specific target. The assay correctly detected only the intended targets with no cross-reactivity identified. The pathogen was detected in all spiked matrices and not detected in the negative non-spiked specimens. This rapid diagnostic assay may permit quicker diagnosis of RBF patients.
Asunto(s)
Zoonosis Bacterianas/microbiología , Fiebre por Mordedura de Rata/microbiología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Streptobacillus/clasificación , Streptobacillus/aislamiento & purificación , Animales , Clonación Molecular , Humanos , Reproducibilidad de los Resultados , Especificidad de la EspecieRESUMEN
Rat-bite fever caused by Streptobacillus moniliformis is a rare infection that may be fatal. An adolescent male presented with multiorgan failure, negative blood cultures and Gram-negative rods in blood smear. S. moniliformis was identified by 16S ribosomal RNA gene sequencing from the blood. He developed systemic hyperinflammatory syndrome resembling hemophagocytic lymphohistiocytosis, for which immune-globulins and steroids were added to the antibiotic regimen and he rapidly recovered.
Asunto(s)
Ceftriaxona/uso terapéutico , Dexametasona/uso terapéutico , Inmunoglobulinas Intravenosas/uso terapéutico , Linfohistiocitosis Hemofagocítica/patología , Fiebre por Mordedura de Rata/diagnóstico , Streptobacillus/aislamiento & purificación , Adolescente , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Antiinflamatorios/administración & dosificación , Antiinflamatorios/uso terapéutico , Ceftriaxona/administración & dosificación , Dexametasona/administración & dosificación , Doxiciclina/administración & dosificación , Doxiciclina/uso terapéutico , Humanos , Linfohistiocitosis Hemofagocítica/tratamiento farmacológico , Masculino , Fiebre por Mordedura de Rata/complicaciones , Fiebre por Mordedura de Rata/microbiologíaRESUMEN
Streptobacillus felis is a fastidious microorganism and a novel member of the potentially zoonotic bacteria causing rat bite fever. Since its description, this is the second isolation of S. felis in a diseased member of the Felidae. Interestingly, the strain from this study was isolated from a zoo held, rusty-spotted cat (Prionailurus rubiginosus), with pneumonia, thereby indicating a possible broader host range in feline species. A recent preliminary sampling of domestic cats (Felis silvestris forma catus) revealed that this microorganism is common in the oropharynx, suggesting that S. felis is a member of their normal microbiota. Due to unawareness, fastidiousness, antibiotic sensitivity and lack of diagnostics the role of S. felis as a cat and human pathogen might be under-reported as with other Streptobacillus infections. More studies are necessary to elucidate the role of S. felis in domestic cats and other Felidae in order to better estimate its zoonotic potential.
Asunto(s)
Felidae , Orofaringe/microbiología , Streptobacillus/clasificación , Streptobacillus/aislamiento & purificación , Animales , Técnicas de Tipificación Bacteriana , Gatos , Reservorios de Enfermedades , Genoma , Genómica/métodos , Fenotipo , Filogenia , Fiebre por Mordedura de Rata/microbiología , Fiebre por Mordedura de Rata/transmisión , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Streptobacillus/química , Streptobacillus/genéticaRESUMEN
A 71-year-old man was admitted with confusion having been discovered on the floor of his unkempt home. Social services would later confirm that the home was infested by rats. An infection of unclear origin was suspected, and he was immediately started on broad spectrum antibiotics. He subsequently developed a swollen left knee. Two knee aspirates showed a raised white cell count but no microbiological or cytological diagnosis. Finally, samples sent for 16S rDNA PCR identified Streptobacillus monilliformis Fastidious organisms and early treatment with antibiotics can limit microbiological diagnosis through standard laboratory analysis. Newer techniques such as sequence-based testing can overcome these limitations; however, they are not widely available and require the clinician to have a high index of suspicion. Crucially, the patient continued to be treated for his clinical sepsis despite initial laboratory results being negative and conflicting specialist opinions.
Asunto(s)
Antibacterianos/uso terapéutico , Fiebre por Mordedura de Rata/tratamiento farmacológico , Streptobacillus/genética , Líquido Sinovial/microbiología , Administración Intravenosa , Anciano , Animales , Diagnóstico Diferencial , Humanos , Masculino , Reacción en Cadena de la Polimerasa/métodos , Fiebre por Mordedura de Rata/diagnóstico , Ratas , Streptobacillus/aislamiento & purificación , Resultado del TratamientoRESUMEN
From a phlegmon in a dog an aerobic and facultatively anaerobic, indole-, oxidase- and catalase-negative, non-motile bacterium was isolated in 2019 in Germany that stained Gram-negative and showed a pleomorphic, rod-shaped, non-spore-forming appearance. Based on the results of 16S rRNA gene sequence analyses, strain IHIT1603-19T was assigned to the genus Streptobacillus with sequence similarities of 98.6, 98.0, 97.9, 97.1 and 94.4â% to the type strains of Streptobacillus felis, Streptobacillus notomytis, Streptobacillus ratti, Streptobacillus moniliformis and Streptobacillus hongkongensis, respectively. Strain IHIT1603-19T could also clearly be differentiated from other Streptobacillus species by rpoB, groEL and recA gene, nucleotide and amino acid sequence analyses as well as by core genome phylogeny. Regarding DNA-DNA relatedness, strain IHIT1603-19T demonstrated an average nucleotide identity of 83.00 and 82.28â% compared to S. felis 131000547T and S. moniliformis DSM 12112T, respectively. Chemotaxonomic and physiological data of strain IHIT1603-19T were in congruence with other closely related members of the family Leptotrichiaceae, represented by highly similar enzyme profiles and fatty acid patterns. MALDI-TOF MS analysis also proved suitable in unequivocally discriminating strain IHIT1603-19T from all currently described taxa of the genus Streptobacillus. On the basis of these data, we propose the novel species Streptobacillus canis sp. nov. with the type strain IHIT1603-19T (=DSM 110501T=CCUG 74118T=CIP 111795T). The G+C content of the DNA of the type strain is 26.6âmol%, genome size is 1.60 Mbp.
Asunto(s)
Perros/microbiología , Filogenia , Streptobacillus/clasificación , Animales , Técnicas de Tipificación Bacteriana , Composición de Base , ADN Bacteriano/genética , Ácidos Grasos/química , Genes Bacterianos , Alemania , Hibridación de Ácido Nucleico , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN , Streptobacillus/aislamiento & purificaciónAsunto(s)
Bacteriemia/diagnóstico , Infecciones por Bacterias Gramnegativas/diagnóstico , Fiebre por Mordedura de Rata/diagnóstico , Anciano , Animales , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Bacteriemia/microbiología , Cultivo de Sangre , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Humanos , Masculino , Fiebre por Mordedura de Rata/tratamiento farmacológico , Fiebre por Mordedura de Rata/microbiología , Ratas , Streptobacillus/aislamiento & purificación , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Bacteriemia/microbiología , Bacteriemia/diagnóstico , Streptobacillus/aislamiento & purificación , Fiebre por Mordedura de Rata/microbiología , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Fiebre por Mordedura de Rata/diagnóstico , Fiebre por Mordedura de Rata/tratamiento farmacológicoAsunto(s)
Mordeduras y Picaduras/microbiología , Embolia/microbiología , Endocarditis Bacteriana/microbiología , Isquemia/microbiología , Extremidad Inferior/irrigación sanguínea , Fiebre por Mordedura de Rata/microbiología , Streptobacillus/aislamiento & purificación , Adulto , Amputación Quirúrgica , Animales , Antibacterianos/uso terapéutico , Mordeduras y Picaduras/complicaciones , Mordeduras y Picaduras/diagnóstico , Mordeduras y Picaduras/tratamiento farmacológico , Enfermedad Crítica , Embolia/diagnóstico , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/tratamiento farmacológico , Femenino , Humanos , Isquemia/diagnóstico por imagen , Isquemia/fisiopatología , Isquemia/cirugía , Fiebre por Mordedura de Rata/diagnóstico , Fiebre por Mordedura de Rata/tratamiento farmacológico , Ratas , Resultado del TratamientoAsunto(s)
Mordeduras y Picaduras/complicaciones , Exantema/etiología , Fiebre por Mordedura de Rata/diagnóstico , Ratas , Streptobacillus/aislamiento & purificación , Animales , Diagnóstico Diferencial , Humanos , Lactante , Masculino , Fiebre por Mordedura de Rata/complicaciones , Fiebre por Mordedura de Rata/tratamiento farmacológico , Sinovitis/diagnóstico por imagen , Sinovitis/etiología , UltrasonografíaRESUMEN
We report a case of rat-bite fever in a 94-year-old woman with Streptobacillus notomytis infection. We established an epidemiologic link between exposure to rats and human infection by performing nested PCRs that detected S. notomytis in the intraoral swab specimens obtained from rats captured in the patient's house.
Asunto(s)
Fiebre por Mordedura de Rata/diagnóstico , Streptobacillus/aislamiento & purificación , Anciano de 80 o más Años , Animales , Enfermedades Transmisibles Emergentes , Diagnóstico Diferencial , Femenino , Humanos , Japón/epidemiología , Reacción en Cadena de la Polimerasa , ARN Ribosómico 16S/genética , Fiebre por Mordedura de Rata/microbiología , Ratas , Enfermedades de los Roedores/epidemiología , Enfermedades de los Roedores/microbiología , Streptobacillus/genéticaRESUMEN
Rat bite fever due to Streptobacillus moniliformis induces typical but not pathognomonic clinical signs, such as local purulent wound infection followed by maculopapular exanthema, myalgia as well as purulent joint infections. Severe complications, such as osteomyelitis and endocarditis are possible. it seems that this infection is rarely diagnosed but this infection could be much more common because the final diagnostic proof is difficult to achieve. Firstly, the culture of these bacteria is critical because the bacteria are fastidious and secondly the exact differentiation of the isolates is hardly possible by standard laboratory methods. Modern techniques such as mass spectroscopy (MALDI-TOF) and molecular biology allow a precise clarification. Surgical cleansing of infection sites in combination with a rational antibiotic therapy, for example with beta-lactam antibiotics, are generally able to cure the infection if treatment is started early enough. In addition, vaccinations, for example against tetanus and rabies have to be considered in this situation as for all other bite wound infections.
Asunto(s)
Mordeduras y Picaduras/terapia , Fiebre por Mordedura de Rata/diagnóstico , Fiebre por Mordedura de Rata/terapia , Ratas , Streptobacillus/aislamiento & purificación , Animales , Antibacterianos/uso terapéutico , Mordeduras y Picaduras/complicaciones , Mordeduras y Picaduras/microbiología , Fiebre por Mordedura de Rata/complicaciones , Fiebre por Mordedura de Rata/microbiología , Ratas/microbiologíaRESUMEN
Rat-bite fever (RBF) is a disease that usually presents with fever, arthralgia and skin rash. Streptobacillus moniliformis was considered the main cause of RBF among the genus Streptobacillus. Although with similar clinical presentation, RBF due to Streptobacillus notomytis is unusual in humans. To the best of our knowledge, we present a case involving the first isolate of S. notomytis in humans. A 63-year-old woman was admitted to our hospital with fever, rash and polyarthritis. She recalled being bitten by a rat on her finger 5 days before presentation. Clinical manifestations were compatible with rat-bite fever (RBF) and the diagnosis was confirmed by the detection of Streptobacillus species from both blood and pustule samples. Initial polymerase chain reaction tests revealed that the organism was S. moniliformis. However, thorough genetic analysis revealed the organism to be S. notomytis. The condition was successfully treated with ampicillin.
Asunto(s)
Vesícula/microbiología , Fiebre por Mordedura de Rata/diagnóstico , Fiebre por Mordedura de Rata/microbiología , Streptobacillus/aislamiento & purificación , Administración Intravenosa , Ampicilina/uso terapéutico , Animales , Antibacterianos/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , ARN Ribosómico 16S/genética , Fiebre por Mordedura de Rata/sangre , Fiebre por Mordedura de Rata/tratamiento farmacológico , Ratas , Streptobacillus/genéticaAsunto(s)
Artralgia/microbiología , Artritis Psoriásica/microbiología , Infecciones por Fusobacterium/tratamiento farmacológico , Infecciones por Fusobacterium/microbiología , Streptobacillus/aislamiento & purificación , Enfermedad Aguda , Adulto , Antibacterianos/uso terapéutico , Artralgia/tratamiento farmacológico , Artritis Psoriásica/tratamiento farmacológico , Diagnóstico Diferencial , Humanos , Masculino , Resultado del TratamientoRESUMEN
We report acute tetraplegia caused by rat bite fever in a 59-year old man (snake keeper) and transmission of Streptobacillus moniliformis. We found an identical characteristic bacterial pattern in rat and human samples, which validated genotyping-based evidence for infection with the same strain, and identified diagnostic difficulties concerning infection with this microorganism.