Abstract: Rat bite fever is a rare zoonotic infection caused by the pleomorphic gram-negative rod, Streptobacillus moniliformis. Schottmuler first identified S moniliformis as the causative organism of rat bite fever in 1914. Although a bite is not required to contract rat bite fever, it seems that the risk of infection after a rat bite is approximately 10%. In fact, 34% of the reported cases did not report a known bite. The disease is typically characterized by vague symptoms such as fever, rigors, maculopapular to petechial rash, migratory polyarthralgias, headache, nausea/vomiting, sore throat, and severe myalgias. Detailed social history and exposure to rats are key to the diagnosis. Untreated, rat bite fever can carry a mortality rate of 10%. Patients with endocarditis carry a 53% mortality rate. Other known complications of rat bite fever include myocarditis, pericarditis, systemic vasculitis, polyarteritis nodosa, meningitis, hepatitis, nephritis, pneumonia, and focal abscesses.