Translational Medicine ReportsStreptobacillus moniliformis With Features of Hemophagocytic Lymphohistiocytosis Identified by Direct SequencingHeaton, Phillip PhD*; Schultz, Noah H.†; Helseth, Peter H. MD‡; Cassis-Ghavami, Farah L. MD§; Hansen, Glen PhD¶,‖; Schultz, Kris Ann P. MD†; Messinger, Yoav H. MD†Author Information From the *Medical Laboratory, Regions Hospital, St. Paul, Minnesota †Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, Minnesota ‡Pathology & Laboratory Medicine, Children’s Minnesota, Minneapolis, Minnesota §Pediatric Infectious Disease, Children’s Minnesota, Minneapolis, Minnesota ¶Department of Pathology & Laboratory Medicine, Hennepin County Medical Center, Minneapolis, Minnesota ‖Department of Pathology & Laboratory Medicine, University of Minnesota, Minneapolis, Minnesota. Accepted for publication June 15, 2020. The authors have no funding or conflicts of interest to disclose. K.A.P.S. and Y.H.M. contributed equally to this report. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.pidj.com). Address for correspondence: Yoav H. Messinger, MD, Cancer and Blood Disorders, Children’s Minnesota, 2525 Chicago Ave. S., Minneapolis, MN 55404. E-mail: [email protected]. The Pediatric Infectious Disease Journal: December 2020 - Volume 39 - Issue 12 - p 1131-1133 doi: 10.1097/INF.0000000000002871 Buy SDC Metrics Abstract Rat-bite fever caused by Streptobacillus moniliformis is a rare infection that may be fatal. An adolescent male presented with multiorgan failure, negative blood cultures and Gram-negative rods in blood smear. S. moniliformis was identified by 16S ribosomal RNA gene sequencing from the blood. He developed systemic hyperinflammatory syndrome resembling hemophagocytic lymphohistiocytosis, for which immune-globulins and steroids were added to the antibiotic regimen and he rapidly recovered. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.