DOCSLIB.ORG

Rat Bite Fever Without the Bite

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Rat Bite Fever Without the Bite Annals ofthe Rheumatic Diseases 1992; 51: 411-412 41 Ann Rheum Dis: first published as 10.1136/ard.51.3.411 on 1 March 1992. Downloaded from Rat bite fever without the bite J N Fordham, E McKay-Ferguson, A Davies, T Blyth Abstract transaminase 48 IU/l; y-glutamyltransferase 134 The case isreported ofa patient who developed IU/1; and bilirubin 34 [imol/l, rising to 49 an acute arthropathy, which was initially [tmol/1; alkaline phosphatase 210 IU/1. Chest diagnosed as acute septic arthritis. The true radiography showed basal pneumonic changes. diagnosis ofrat bite feverdue toStreptobacillus A diagnosis of septic arthritis was made and moniliformis was delayed because of difficulty the right knee was aspirated. Purulent synovial in growing the organism, which has fastidious fluid (10 ml) was withdrawn, and on direct film growth requirements. The patient had no a cluster of cocci, loosely arranged 'like a bunch history of rat bite, which is the usual form of of grapes', was seen. The organisms were transmission of this disease. identified as 'probably Staphylococcus aureus'. He was treated with flucloxacillin 1 g four times a day and sodium fusidate 500 mg three times a Rat bite fever presents as an acute or chronic day, both given intravenously. Over the course illness characterised by polyarthralgia or poly- of the next six days he developed a widespread arthritis affecting the knees, shoulders, elbows, morbilliform rash, thought to be induced by the wrists, and hands. Other features are cough, antibiotics. Flucloxacillin was stopped and malaise, rash, chills, and fever.' The condition treatment was started with intravenous vanco- is due to infection by Streptobacillus moniliformis mycin 1 g twice a day. or, less commonly, by Spirillum minus.2 The Twelve days after admission the synovial mode of transfer is by a bite from an infected fluid bacteriological report showed 'Grain rat, mouse, or similar rodent3 or ingestion of negative bacillus present throughout the food or milk4 or water contaminated by rat enrichment'. Two weeks after admission the excreta.5 Characteristically, the area of the bite organism was identified as Streptobacillus seems to be healing at the time of development moniliformis and was found to be 'very sensitive of severe myalgia and arthralgia and at that to penicillin'. At this stage the patient had a stage the bite becomes inflamed and there is normal temperature, his joints had completely http://ard.bmj.com/ local lymphadenopathy.2 In the chronic form returned to normal, and the chest radiograph recurrent bouts of fever occur lasting for several had cleared. He was discharged a few weeks days at a time and often associated with rigor, after admission, and on review 10 weeks later nausea, and headache. The rash is character- the patient had no residual joint signs other than istically erythematous, sometimes pustular, and bilateral quadriceps wasting. petechial haemorrhages may also occur.6 (In spirillum infection lymphadenopathy and on September 24, 2021 by guest. Protected copyright. splenomegaly may occur.) Rarely, myositis, Discussion endocarditis abscesses, splenic and renal Both Streptobacillus moniliformis and Spirillum infarctions may complicate the course of the minus have worldwide distribution. Strepto- illness.2 3 bacillus moniliformis is responsible for most of the rat bite fever recorded in America. Its natural habitus is the rat respiratory tract, being Case history present in up to 50% of healthy rats,7 and is A 63 year old pig farmer was admitted with a rarely transmitted to humans.8 five day history of malaise and anorexia. Three Streptobacillus moniliformis is extremely diffi- days before admission he had developed painful cult to identify because of its fastidious growth swelling of the ankles and a petechial rash over requirements and variable staining and mor- the feet and had been febrile with rigors. On phology.9 It is classified as a Gram negative Department of admission he had joint effusions affecting both rod but may retain the Gram stain and adopt Rheumatology, knees and right wrist. Cervical spinal movements coccal forms (McKay-Ferguson E, personal South Cleveland Hospital, were restricted and very painful. He had a communication). Marton Road, temperature of 38-9°C and there was a petechial Because of the difficulty in culturing the Middlesbrough, rash affecting the dorsum of both feet. There organism the diagnosis was delayed for two Cleveland TS4 3BW, were weeks. United Kingdom expiratory crackles throughout both lung The organism was cultured eventually J N Fordham fields. There was a small pustule over the right from an enrichment culture (Robertson's cooked E McKay-Ferguson olecranon. meat medium). Sodium polyanethol sulphonate, A Davies Investigations showed a plasma viscosity of which is present in many blood culture systems T Blyth 1 87 mPa.s; haemoglobin 120 g/l, later falling as an anticoagulant, might have contributed to Correspondence to: Dr Fordham. to 106 g/l; white cell count 13 2x 109/1, rising to the delay, and this has been shown to inhibit Accepted for publication 18 5x109/1; platelets 339x109/1, rising to growth of some strains of Streptobacillus monili- 29 May 1991 631 x109/l. Liver function tests showed alanine formis. 0 I I 412 Fordham, McKay-Ferguson, Davies, Blyth The initial choice of treatment with fluclo- infection. Treatment with penicillins, which xacillin was satisfactory, as was subsequent will eradicate the organism causing septic Ann Rheum Dis: first published as 10.1136/ard.51.3.411 on 1 March 1992. Downloaded from treatment with Vancomycin, and disc diffusion arthritis, will usually be effective in rat bite tests confirmed both antibiotics to have been fever, Lyme disease, and gonococcal arthritis. appropriate. Both penicillin and vancomycin act Our patient presented with a short history of by interfering with bacterial cell wall synthesis arthralgia and subsequently arthritis associated and are much more active against Gram positive with rigors and rash. The absence of readily than Gram negative bacteria (with the exception available serological tests for this organism and ofcertain Gram negative cocci such as neisserias). lack of any clear history of origin for the The satisfactory clinical outcome in this case infection retarded the correct diagnosis being supports the conclusion that Streptobacillus made. We would like to draw attention to the moniliformis should properly be regarded as a possibility of rat bite fever as a cause of Gram positive organism. pyogenic arthritis, particularly where initial There was no history of rat bite, but, pos- microbiological analysis has been unrevealing. sibly, inhalation or gastrointestinal absorption of excreta might have been the portal of entry. The piggery had been infested with rats and the 1 Murray H W. Streptobacillus moniliformis (rat bite fever). patient remembered numerous episodes of In: Mandell G L, Douglas R G, Bennett J E, eds. Principles grazing the skin of both elbows on the sides of and practices ofinfectious disease. 2nd ed. New York: Wiley, 1985: 1305-6. the pig pens. It is possible, therefore, that 2 Huskisson E C, Dudley Hart F. Joint disease: all the inoculation ofthis organism might have occurred arthropathies. Bristol, London: Wright, 1987: 122. 3 McGill R C, Martin A M, Edmunds P N. Rat bite fever due through this route. Two recent reports from to Streptobacillus moniliformis. BMJ 1%6; i: 1213-4. America also note streptobacillus infections 4 Parker F, Hudson N P. The aetiology of Haverhill fever (erythema arthriticum epidemicum). Am J Pathol 1926; 2: which occurred without a history of rat bites: a 357-79. 48 year old warehouse fork-lift operator who 5 McEvoy M B, Noah N D, Pilsworth R. Outbreak of fever caused by Streptobacillus moniliformis. Lancet 1987; ii: had a three month history ofgradually increasing 1361-3. symptoms before diagnosis, and a 59 year old 6 Shanson D C, Gazzard B G, Midgley J, et al. Streptobacillus moniliformis isolated from blood in four cases of Haverhill alcoholic man who had a one month history of fever. First outbreak in Britain. Lancet 1983; ii: 92-4. arthritic symptoms before diagnosis. In neither 7 Strangeways W I. Rats as carriers of Streptobacillus moni- liformis. J Pathol Bacteriol 1983; 37: 45-51. of these cases had any recollection of contact 8 Anderson L C, Leary S L, Manning P J. Rat bite fever in with rats or of a rat bite been noted.'2 13 animal research laboratory personnel. Lab Anim Sci 1983; 33: 292-4. The differential diagnosis in this case would 9 Rogosa M. Streptobacillus moniliformis and Spirillum include other causes of septic arthritis, such as minus. In: Lennette E H, Balows A, Hausler W J, Shawdomy H J, eds, Manual ofclinical microbiology. 4th ed. Lyme disease and gonococcal arthritis and Washington DC: American Society for Microbiology, 1984: brucella, as well as other non-infectious inflam- 400-6. 10 Lamb D W, McPhedran A M, Mertz J, Stewart P. matory polyarthropathies, including rheumatoid Streptobacillus moniliformis isolated from a case of arthritis. 13 Haverhill fever: biochemical characterisation and inhibitory effect of sodium polyanethol sulfate. Am J Clin Pathol http://ard.bmj.com/ Presentation with fever and rash may mimic 1973; 60: 854-60. systemic lupus erythematosus, drug reactions, 11 Shanson D C, Pratt J, Greene P. Comparison of media with and without Panmede for the isolation of Streptobacilius viral infections, rickettsial infections, and moniliformis from blood cultures and observations on the secondary syphilis. inhibition of sodium polyanethol sulphonate. J Med Microbiol 1985; 19: 181-6. Of cases of septic arthritis in adults, up to 12 Rumley R L, Patrone N A, White L. Rat bite fever as a cause 60% are due to staphylococci, with streptococci of septic arthritis. Ann Rheum Dis 1987; 46: 793-5. 13 Holroyd K J, Reiner A P, Dick J D.
Load more

Recommended publications
  • A Review of Outbreaks of Infectious Disease in Schools in England and Wales 1979-88 C
    Epidemiol. Infect. (1990), 105, 419-434 419 Printed in Great Britain A review of outbreaks of infectious disease in schools in England and Wales 1979-88 C. JOSEPH1, N. NOAH2, J. WHITE1 AND T. HOSKINS3 'Public Health Laboratory Service, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ 2Kings College School o Medicine and Dentistry, Bessemer Road, London SE5 9PJ 3 Christs Hospital, Horsham, Sussex (Accepted 20 May 1990) SUMMARY In this review of 66 outbreaks of infectious disease in schools in England and Wales between 1979-88, 27 were reported from independent and 39 from maintained schools. Altogether, over 8000 children and nearly 500 adults were affected. Most of the outbreaks investigated were due to gastrointestinal infections which affected about 5000 children; respiratory infections affected a further 2000 children. Fifty-two children and seven adults were admitted to hospital and one child with measles died. Vaccination policies and use of immunoglobulin for control and prevention of outbreaks in schools have been discussed. INTRODUCTION The prevention and control of infectious disease outbreaks in schools are important not only because of the number of children at risk but also because of the potential for spread of infection into families and the wider community. Moreover, outbreaks of infection in such communities may lead to serious disruption of children's education and the curtailment of school activities. Details made available of 66 school outbreaks to the Communicable Disease Surveillance Centre between 1979 and 1988 are analysed in this paper and policies for prophylaxis, for example immunoglobulin and vaccination are described. SOURCES OF INFORMATION Information on outbreaks in schools between 1979 and 1988 was obtained from reports of investigations in which the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC) had been asked to assist [1] and Communicable Disease Report (CDR) inserts (Table 1).
    [Show full text]
  • Melioidosis in Birds and Burkholderia Pseudomallei Dispersal, Australia
    LETTERS 5. Mätz-Rensing K, Jentsch KD, Rensing S, Melioidosis in Birds However, these are mostly birds Langenhuynsen S, Verschoor E, Niphuis in captivity and often exotic to the H, et al. Fatal herpes simplex infection in and Burkholderia a group of common marmosets (Callithrix location, suggesting potential reduced jacchus). Vet Pathol. 2003;40:405–11. pseudomallei immunity. Little is known about doi:10.1354/vp.40-4-405 Dispersal, Australia melioidosis in wild birds. In Sabah, 6. Bruno SF, Liebhold M, Mätz-Rensing K, Malaysia, only 1 of 440 wild birds Romão MA, Didier A, Brandes A, et al. Herpesvirus infection in free-living black- To the Editor: Melioidosis is an admitted to a research center over 9 tufted-ear marmoset (Callithrix penicil- emerging infectious disease of humans years was found to have melioidosis lata E. Geoffroyi 1812) at the state park of and animals caused by the gram- (6). Serra da Tiririca, Niterói, Rio de Janeiro, negative bacterium Burkholderia Although birds are endotherms, Brazil. Berl Munch Tierarztl Wochenschr. 1997;110:427–30. pseudomallei, which inhabits soil and with high metabolic rates and body 7. Kalter SS, Heberling RL. Comparative surface water in the disease-endemic temperature (40°C–43°C) protecting virology of primates. Bacteriol Rev. regions of Southeast Asia and northern them from many diseases, some birds 1971;35:310–64. Australia (1). The aim of this study appear more susceptible to melioidosis. 8. Mansfi eld K. Emerging and re-emerging infectious diseases of nonhuman primates. was to assess the potential for birds Indeed, high body temperature would Proceedings of the American College to spread B.
    [Show full text]
  • Anaplasmosis: an Emerging Tick-Borne Disease of Importance in Canada
    IDCases 14 (2018) xxx–xxx Contents lists available at ScienceDirect IDCases journal homepage: www.elsevier.com/locate/idcr Case report Anaplasmosis: An emerging tick-borne disease of importance in Canada a, b,c d,e e,f Kelsey Uminski *, Kamran Kadkhoda , Brett L. Houston , Alison Lopez , g,h i c c Lauren J. MacKenzie , Robbin Lindsay , Andrew Walkty , John Embil , d,e Ryan Zarychanski a Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada b Cadham Provincial Laboratory, Government of Manitoba, Winnipeg, MB, Canada c Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada d Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Internal Medicine, Section of Medical Oncology and Hematology, University of Manitoba, Winnipeg, MB, Canada e CancerCare Manitoba, Department of Medical Oncology and Hematology, Winnipeg, MB, Canada f Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Pediatrics and Child Health, Section of Infectious Diseases, Winnipeg, MB, Canada g Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Internal Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada h Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada i Public Health Agency of Canada, National Microbiology Laboratory, Zoonotic Diseases and Special Pathogens, Winnipeg, MB, Canada A R T I C L E I N F O A B S T R A C T Article history: Human Granulocytic Anaplasmosis (HGA) is an infection caused by the intracellular bacterium Received 11 September 2018 Anaplasma phagocytophilum.
    [Show full text]
  • Reportable Disease Surveillance in Virginia, 2013
    Reportable Disease Surveillance in Virginia, 2013 Marissa J. Levine, MD, MPH State Health Commissioner Report Production Team: Division of Surveillance and Investigation, Division of Disease Prevention, Division of Environmental Epidemiology, and Division of Immunization Virginia Department of Health Post Office Box 2448 Richmond, Virginia 23218 www.vdh.virginia.gov ACKNOWLEDGEMENT In addition to the employees of the work units listed below, the Office of Epidemiology would like to acknowledge the contributions of all those engaged in disease surveillance and control activities across the state throughout the year. We appreciate the commitment to public health of all epidemiology staff in local and district health departments and the Regional and Central Offices, as well as the conscientious work of nurses, environmental health specialists, infection preventionists, physicians, laboratory staff, and administrators. These persons report or manage disease surveillance data on an ongoing basis and diligently strive to control morbidity in Virginia. This report would not be possible without the efforts of all those who collect and follow up on morbidity reports. Divisions in the Virginia Department of Health Office of Epidemiology Disease Prevention Telephone: 804-864-7964 Environmental Epidemiology Telephone: 804-864-8182 Immunization Telephone: 804-864-8055 Surveillance and Investigation Telephone: 804-864-8141 TABLE OF CONTENTS INTRODUCTION Introduction ......................................................................................................................................1
    [Show full text]
  • Leptospirosis Associated Equine Recurrent Uveitis Answers to Your Important Questions What Is Leptospirosis Associated Equine Recurrent Uveitis (LAERU)?
    Lisa Dauten, DVM Tri-State Veterinary Services LLC " Leptospirosis Associated Equine Recurrent Uveitis Answers to your Important Questions! What is Leptospirosis Associated Equine Recurrent Uveitis (LAERU)? Let’s start by breaking down some terminology.! Uveitis- inflammation of the uvea. Resulting in cloudiness of the eye, pain, and potential blindness. Also know as “Moon Blindness”. Caused by trauma, infection, or corneal disease.! Uvea- part of the eye containing the iris, ciliary body, and choroid. It keeps the lens of the eye in place, maintains fluid in the eye, and keeps things in the blood from entering the inside of the eye (blood-ocular barrier). ! Recurrent Uveitis- inflammation of the uvea that sporadically reoccurs through out a horses life time. Each time there is a reoccurring episode, the damage to the eye is made worse, eventually leading to permanent damage and potential blindness. ! Leptospirosis- bacteria found in the environment shed in the urine of wildlife and livestock. Horses usually are exposed when grazing pastures or drinking from natural water sources.! LAERU- Recurrent Uveitis in horses caused by Leptospirosis.! What are the clinical signs of Uveitis? Uveitis can come on very suddenly. A lot of times horses present with severe pain in the eye, tearing, squinting, and rubbing face. The eye itself is cloudy, white or blue in color. Sometimes the signs are not as dramatic. The color change of the eye may progress slowly. In these cases, horse owners may mistake the changes for cataracts.! What do I do if I think my horse has Uveitis? Call your veterinarian to request an appointment.
    [Show full text]
  • Tick-Borne Diseases in Maine a Physician’S Reference Manual Deer Tick Dog Tick Lonestar Tick (CDC Photo)
    tick-borne diseases in Maine A Physician’s Reference Manual Deer Tick Dog Tick Lonestar Tick (CDC PHOTO) Nymph Nymph Nymph Adult Male Adult Male Adult Male Adult Female Adult Female Adult Female images not to scale know your ticks Ticks are generally found in brushy or wooded areas, near the DEER TICK DOG TICK LONESTAR TICK Ixodes scapularis Dermacentor variabilis Amblyomma americanum ground; they cannot jump or fly. Ticks are attracted to a variety (also called blacklegged tick) (also called wood tick) of host factors including body heat and carbon dioxide. They will Diseases Diseases Diseases transfer to a potential host when one brushes directly against Lyme disease, Rocky Mountain spotted Ehrlichiosis anaplasmosis, babesiosis fever and tularemia them and then seek a site for attachment. What bites What bites What bites Nymph and adult females Nymph and adult females Adult females When When When April through September in Anytime temperatures are April through August New England, year-round in above freezing, greatest Southern U.S. Coloring risk is spring through fall Adult females have a dark Coloring Coloring brown body with whitish Adult females have a brown Adult females have a markings on its hood body with a white spot on reddish-brown tear shaped the hood Size: body with dark brown hood Unfed Adults: Size: Size: Watermelon seed Nymphs: Poppy seed Nymphs: Poppy seed Unfed Adults: Sesame seed Unfed Adults: Sesame seed suMMer fever algorithM ALGORITHM FOR DIFFERENTIATING TICK-BORNE DISEASES IN MAINE Patient resides, works, or recreates in an area likely to have ticks and is exhibiting fever, This algorithm is intended for use as a general guide when pursuing a diagnosis.
    [Show full text]
  • Rat Bite Fever Due to Streptobacillus Moniliformis a CASE TREATED by PENICILLIN by F
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by PubMed Central Rat Bite Fever Due to Streptobacillus Moniliformis A CASE TREATED BY PENICILLIN By F. F. KANE, M.D., M.R.C.P.I., D.P.H. Medical Superintendent, Purdysburn Fever Hospital, Belfast IT is unlikely that rat-bite fever will rver become a public health problem in this country, so the justification for publishing the following case lies rather in its rarity, its interesting course and investigation, and in the response to Penicillin. PRESENT CASE. The patient, D. G., born on 1st January, 1929, is the second child in a family of three sons and one daughter of well-to-do parents. There is nothing of import- ance in the family history or the previous history of the boy. Before his present illness he was in good health, was about 5 feet 9j inches in height, and weighed, in his clothes, about 101 stone. The family are city dwellers. On the afternoon of 18th March, 1944, whilst hiking in a party along a country lane about fifteen miles from Belfast city centre, he was bitten over the terminal phalanx of his right index finger by a rat, which held on until pulled off and killed. The rat was described as looking old and sickly. The wound bled slightly at the time, but with ordinary domestic dressings it healed within a few days. Without missing a day from school and feeling normally well in the interval, the boy became sharply ill at lunch-time on 31st March, i.e., thirteen days after the bite.
    [Show full text]
  • Wildlife Diseases and Humans
    Robert G. McLean Chief, Vertebrate Ecology Section Medical Entomology & Ecology Branch WILDLIFE DISEASES Division of Vector-borne Infectious Diseases National Center for Infectious Diseases AND HUMANS Centers for Disease Control and Prevention Fort Collins, Colorado 80522 INTRODUCTION GENERAL PRECAUTIONS Precautions against acquiring fungal diseases, especially histoplasmosis, Diseases of wildlife can cause signifi- Use extreme caution when approach- should be taken when working in cant illness and death to individual ing or handling a wild animal that high-risk sites that contain contami- animals and can significantly affect looks sick or abnormal to guard nated soil or accumulations of animal wildlife populations. Wildlife species against those diseases contracted feces; for example, under large bird can also serve as natural hosts for cer- directly from wildlife. Procedures for roosts or in buildings or caves contain- tain diseases that affect humans (zoo- basic personal hygiene and cleanliness ing bat colonies. Wear protective noses). The disease agents or parasites of equipment are important for any masks to reduce or prevent the inhala- that cause these zoonotic diseases can activity but become a matter of major tion of fungal spores. be contracted from wildlife directly by health concern when handling animals Protection from vector-borne diseases bites or contamination, or indirectly or their products that could be infected in high-risk areas involves personal through the bite of arthropod vectors with disease agents. Some of the measures such as using mosquito or such as mosquitoes, ticks, fleas, and important precautions are: tick repellents, wearing special cloth- mites that have previously fed on an 1. Wear protective clothing, particu- ing, or simply tucking pant cuffs into infected animal.
    [Show full text]
  • Tick-Borne Disease Working Group 2020 Report to Congress
    2nd Report Supported by the U.S. Department of Health and Human Services • Office of the Assistant Secretary for Health Tick-Borne Disease Working Group 2020 Report to Congress Information and opinions in this report do not necessarily reflect the opinions of each member of the Working Group, the U.S. Department of Health and Human Services, or any other component of the Federal government. Table of Contents Executive Summary . .1 Chapter 4: Clinical Manifestations, Appendices . 114 Diagnosis, and Diagnostics . 28 Chapter 1: Background . 4 Appendix A. Tick-Borne Disease Congressional Action ................. 8 Chapter 5: Causes, Pathogenesis, Working Group .....................114 and Pathophysiology . 44 The Tick-Borne Disease Working Group . 8 Appendix B. Tick-Borne Disease Working Chapter 6: Treatment . 51 Group Subcommittees ...............117 Second Report: Focus and Structure . 8 Chapter 7: Clinician and Public Appendix C. Acronyms and Abbreviations 126 Chapter 2: Methods of the Education, Patient Access Working Group . .10 to Care . 59 Appendix D. 21st Century Cures Act ...128 Topic Development Briefs ............ 10 Chapter 8: Epidemiology and Appendix E. Working Group Charter. .131 Surveillance . 84 Subcommittees ..................... 10 Chapter 9: Federal Inventory . 93 Appendix F. Federal Inventory Survey . 136 Federal Inventory ....................11 Chapter 10: Public Input . 98 Appendix G. References .............149 Minority Responses ................. 13 Chapter 11: Looking Forward . .103 Chapter 3: Tick Biology, Conclusion . 112 Ecology, and Control . .14 Contributions U.S. Department of Health and Human Services James J. Berger, MS, MT(ASCP), SBB B. Kaye Hayes, MPA Working Group Members David Hughes Walker, MD (Co-Chair) Adalbeto Pérez de León, DVM, MS, PhD Leigh Ann Soltysiak, MS (Co-Chair) Kevin R.
    [Show full text]
  • December 2018
    Louisiana Morbidity Report Office of Public Health - Infectious Disease Epidemiology Section P.O. Box 60630, New Orleans, LA 70160 - Phone: (504) 568-8313 www.ldh.louisiana.gov/LMR John Bel Edwards Infectious Disease Epidemiology Main Webpage Rebekah E. Gee MD MPH GOVERNOR www.infectiousdisease.dhh.louisiana.gov SECRETARY November-December, 2018 Volume 29, Number 6 other means of contact as well as through contaminated food or wa- Death from Rat-bite Fever ter. It can also transmitted by all rodents, not just rats (Photos). Louisiana, 2018 As the name implies, RBF may be transmitted through bites of Photos - Common Rodents: Norway rat courtesy of Orkin, Inc. via cdc.gov; Gary Balsamo, DVM MPH; Julie Hand, MSPH; Marceia Walker, M.Ed squirrel courtesy of Eborutta at wikipedia.org; beaver courtesy of Stephen Hersey, [email protected] In early 2018, a Louisiana resident who possessed and closely interacted with pet rodents, died from the effects of a bacterial infec- tion often referred to as rat-bite fever (RBF). Although a rare illness, the effects of this disease are often very severe. This death serves as a reminder that, although fatal consequences of zoonotic diseases are rare in Louisiana, severe illness or mortality from zoonotic infec- tions is possible. Simple precautions are often all that is required to significantly reduce the risk of these type of infections. RBF can be caused by either Streptobacillus moniliformis (strep- rodents that are colonized by the bacteria; the disease has also been tobacillary RBF) or Spirillum minus (spirillary RBF or sodoku), transmitted through scratches. The causative bacteria is found in the although S.moniliformis is the only known etiology of the disease saliva, urine and feces of the animal; therefore, contamination of in North America.
    [Show full text]
  • Rat-Bite Fever (Streptobac8dlu.S Monilnjiormh) : a Potential Emerging Disease Margot H
    Original Report Rat-Bite Fever (Streptobac8dlu.s monilnjiormh) : A Potential Emerging Disease Margot H. Graves, BS;” and J. Michael Janda, PhD* ABSTRACT Two distinct clinical syndromes have been identified in association with S. moniliformis infection. One, Haver- Objectives: To determine the relative prevalence of human infec- hill fever, originally recognized in 1926, is an infection tions attributable to Streptobacillus moniliformis in California transmitted to humans through the consumption of con- over the past 3 decades. taminated water, milk, or food previously in contact with Methods: A retrospective analysis of all the data collected was rats.‘,* The disease is characterized by a high incidence conducted on S. moniliformis cultures identified by the Micro- of pharyngitis and pronounced vomiting. bial Diseases Laboratory (MDL) from January 1970 to Decem- The more common syndrome associated with S. ber 1998. moniliformis infection, however, is rat-bite fever @RF). This illness is characterized by abrupt onset of high fevers, Results: Information on a total of 45 S. moniliformis isolates headaches, severe migratory arthralgia, vomiting, and a was analyzed. Overall, 91% of the isolates were from human rash (2-4 days later). The petechial rash develops over sources; 58% were received since 1990. These strains were the extremities, in particular the palms and the soles.’ The divided almost equally between males and females, with 50% onset of symptoms typically occurs 10 or more days after of the isolates from patients 9 years old or younger. In 75% of the cases of human infections where a diagnosis was given, exposure. Any related wound has usually healed by the rat-bite fever (RBF) was suspected; 83% of these suspected time symptoms develop.
    [Show full text]
  • Tick-Borne Diseases
    Focus on... Tick-borne diseases DS20-INTGB - June 2017 With an increase in forested areas, The vector: ticks an increase in the number of large mammals, and developments in forest The main vector of these diseases are use and recreational activities, the hard ticks, acarines of the Ixodidae family. In France, more than 9 out of 10 ticks incidence of tick-borne diseases is on removed from humans are Ixodes ricinus the rise. and it is the main vector in Europe of human-pathogenic Lyme borreliosis (LB) In addition to Lyme disease, which has spirochaetes, the tick-borne encephali- an estimated incidence of 43 cases tis virus (TBEV) and other pathogens of per 100,000 (almost 30,000 new cases humans and domesticated mammals. identified in France each year), ticks can It is only found in ecosystems that are transmit numerous infections. favourable to it: deciduous forests, gla- des, and meadows with a temperate Although the initial manifestations of climate and relatively-high humidity. these diseases are often non-specific, Therefore, it is generally absent above a they can become chronic and develop height of 1200-1500 m and from the dry into severe clinical forms, sometimes Mediterranean region. with very disabling consequences. They Its activity is reduced at temperatures respond better to antibiotic treatment if above 25°C and below 7°C. As a result, it is initiated quickly, hence the need for its activity period is seasonal, reaching a early diagnosis. maximum level in the spring and autumn. Larva Adult female Adult male Nymph 0 1.5 cm It is a blood-sucking ectoparasite with 10 days.
    [Show full text]