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Rat Bite Fever

A Case Report and Review of the Literature

Walker, Justin W. BS*; Reyes, Lilia B. MD*†

doi: 10.1097/PEC.0000000000000956
Illustrative Cases

Cases of rat-bite fever (RBF) were reported in the literature for more than 2000 years. Not until recently, however, were attempts made to differentiate between RBF and Streptobacillus moniliformis septic arthritis, 2 arguably different clinical entities. There are limited data regarding S moniliformis septic arthritis and the features that distinguish it from RBF, and most conclude that although clinically disparate diseases, it is difficult to differentiate between them. We report a case of a 17-year-old girl who presented with S moniliformis bacteremia and symptoms that spanned both RBF and S moniliformis septic arthritis. This case emphasizes the difficulty in differentiating the 2 clinical entities and the importance of early diagnosis, proper clinical suspicion, and prompt treatment to achieve positive outcomes.

From the *The Pennsylvania State University College of Medicine; and

Department of Emergency Medicine, Penn State Hershey Medical Center, Hershey, PA.

Disclosure: The authors declare no conflict of interest.

Reprints: Justin Walker, BS, 500 University Dr, Penn State Hershey College of Medicine, Hershey, PA 17033 (e-mail:

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