Streptobacillary fever

Streptobacillary fever, also known as Rat-bite fever (RBF) or Haverhill fever, is an infectious disease caused by two types of bacteria: Streptobacillus moniliformis in North America and Spirillum minus in Asia. The disease is primarily transmitted to humans through bites or scratches from infected rodents, or through the ingestion of contaminated food or water. This article focuses on the streptobacillary form of the disease, which is more common in North America.

Symptoms and Diagnosis

The onset of streptobacillary fever typically occurs 3 to 10 days after exposure to the bacteria, starting with sudden fever, chills, headache, muscle pain, and vomiting. A distinctive rash may also develop, along with joint pain. If left untreated, the infection can lead to more severe complications such as endocarditis, meningitis, or pneumonia.

Diagnosis of streptobacillary fever is primarily based on the patient's history of rodent exposure and clinical symptoms. Laboratory tests, including blood cultures, can confirm the presence of Streptobacillus moniliformis. Polymerase chain reaction (PCR) tests may also be used for more rapid identification of the bacteria.

Treatment

The primary treatment for streptobacillary fever is antibiotics. Penicillin is the antibiotic of choice, but for patients allergic to penicillin, doxycycline or erythromycin can be effective alternatives. Early treatment is crucial to prevent the development of serious complications.

Prevention

Preventive measures against streptobacillary fever include controlling rodent populations in living and working environments, avoiding contact with rodents, and maintaining good hygiene practices to reduce the risk of food and water contamination.

Epidemiology

Streptobacillary fever is relatively rare, with most cases reported in North America. However, sporadic cases have been reported worldwide, particularly in urban areas with high rodent populations. Both children and adults can be affected, but the disease is more common in individuals with occupational or recreational exposure to rodents.

History

The disease was first described in the early 20th century, with the bacterium Streptobacillus moniliformis identified as the causative agent. The term "Haverhill fever" originated from an outbreak in Haverhill, Massachusetts, in 1926, which was traced to the consumption of contaminated milk.