Rat-bite fever (Streptobacillus moniliformis): a potential emerging disease.

OBJECTIVES: To determine the relative prevalence of human infections attributable to Streptobacillus moniliformis in California over the past 3 decades. METHODS: A retrospective analysis of all the data collected was conducted on S. moniliformis cultures identified by the Microbial Diseases Laboratory (MDL) from January 1970 to December 1998. RESULTS: Information on a total of 45 S. moniliformis isolates was analyzed. Overall, 91% of the isolates were from human sources; 58% were received since 1990. These strains were divided almost equally between males and females, with 50% of the isolates from patients 9 years old or younger. In 75% of the cases of human infections where a diagnosis was given, rat-bite fever (RBF) was suspected; 83% of these suspected cases involved either a known rat bite or exposure to rodents. CONCLUSIONS: As crowding becomes an increasing environmental reality, humans are more frequently being exposed to zoonotic diseases as a result of encounters with "wild" animals. Domesticated animals also are exposed more frequently to wild animals; thus, increasing human exposure to once rare zoonotic illnesses. Rat-bite fever is a disease that seems to be easily recognizable by clinicians, easily identified in the clinical laboratory (if suspected), and successfully treated when the appropriate therapy is administered. Physicians should consider RBF as a possible diagnosis when fever, rash, and exposure to rats are part of the patient's history.

Cutaneous abscesses. Anaerobic and aerobic bacteriology and outpatient management.

Specimens from 135 cutaneous abscesses in outpatients were cultured anaerobically and aerobically. Of these, 4% were sterile and 29% yielded pure cultures, predominantly of Staphylococcus aureus. Aerobic species were isolated from all anatomic areas. Anaerobes were found with a frequency comparable to aerobes in all nonperineal areas except the hand. In contrast, abscesses in the perineal region contained a greater variety and frequency of anaerobes. Only two patients were febrile. All abscesses were treated with incision and drainage, and all healed without complication, including those 74% that were treated without adjunctive antibiotics. Primary management of cutaneous abscesses should be incision and drainage. In general, routine culture and antibiotic therapy are not indicated for localized abscesses in patients with presumably normal host defenses.

A rapid glutamic decarboxylase test for identification of bacteria.

A simple rapid glutamic decarboxylase test is described. This test was found useful in the identification of Escherichia coli, Shigella sp., Providencia alcalifaciens, Clostridium perfringens and Bacteroides fragilis.

Sodium polyanethol sulfonate sensitivity of anaerobic cocci.

Growth of Peptostreptococcus anaerobius was shown to be totally inhibited by sodium polyanethol sulfonate (SPS). Other anaerobic cocci grew in the presence of SPS although some strains of Peptococcus prevotii and Peptococcus magnus showed delayed growth. A SPS disk assay for the presumptive identification of P. anaerobius is described.