Rat-bite fever: Difference between revisions

Jump to navigation Jump to search
← Older edit
VisualWikitext
Jyostna Chouturi (talk | contribs)
nocaptcha
9,554 edits
Jyostna Chouturi (talk | contribs)
nocaptcha
9,554 edits
No edit summary
 
(5 intermediate revisions by the same user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
'''For patient information click [[Rat-bite fever (patient information)|here]]'''
'''This page is about clinical aspects of the disease.  For microbiologic aspects of specific causative organisms:'''
{{Seealso|Streptobacillus moniliformis}}
{{Seealso|Spirillum minus}}
{{Rat-bite fever}}
{{Rat-bite fever}}


Line 18: Line 20:


==[[Rat-bite fever causes|Causes]]==
==[[Rat-bite fever causes|Causes]]==
Normal commensal of rodent oropharynx also in ferrets, weasels, gerbils.
Risk factors for acquisition: crowded urban dwellings (especially kids), lab workers.
Transmission: bite/scratch from rat, mice, squirrels—also cats, dogs, pigs.


==[[Rat-bite fever differential diagnosis|Differentiating Rat-bite fever from other Diseases]]==
==[[Rat-bite fever differential diagnosis|Differentiating Rat-bite fever from other Diseases]]==
Differential diagnosis is rash on palms/soles consider RMSF, syphilis. Arthritis- disseminated gonorrhea, Lyme, brucella, endocarditis, rheumatological disease, and rheumatic fever.


==[[Rat-bite fever natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==[[Rat-bite fever natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
Line 30: Line 27:
==Diagnosis==
==Diagnosis==
[[Rat-bite fever history and symptoms|History and Symptoms]] | [[Rat-bite fever physical examination|Physical Examination]] | [[Rat-bite fever laboratory findings|Laboratory Findings]] | [[Rat-bite fever imaging findings|Imaging Findings]] | [[Rat-bite fever other diagnostic studies|Other Diagnostic Studies]]
[[Rat-bite fever history and symptoms|History and Symptoms]] | [[Rat-bite fever physical examination|Physical Examination]] | [[Rat-bite fever laboratory findings|Laboratory Findings]] | [[Rat-bite fever imaging findings|Imaging Findings]] | [[Rat-bite fever other diagnostic studies|Other Diagnostic Studies]]
'''Symptoms'''- incubation for 10-day fever, chills, HA, N/V, migratory arthralgias, leukocytosis. Days 2-4 days: nonpruritic maculopapular, petechial, or pustular rash (palms soles, extremities). May be purpuric/confluent. In 50% pts, polyarthritis (even septic arthritis) with or after onset rash (knees>ankles>elbows>hips). Most symptoms resolve within 2 weeks (even if no abx). Arthritis can persist  for 2 years. Nonzoonotic transmission (orally): aka Haverhill Fever (similar manifestations as RBF). Rodent excrement contaminating water, milk, turkey meat. Milk contamination associated w/ epidemics.
'''Diagnosis'''- Gram or Giemsa stain blood, joint fluid, pus. Perform culture using TSA or blood agar. ELISA or agglutinins (sero-negative within 5 months-2 yrs); PCR.


==Treatment==
==Treatment==
[[Rat-bite fever medical therapy|Medical Therapy]] | [[Rat-bite fever primary prevention|Prevention]]  | [[Rat-bite fever cost-effectiveness of therapy|Cost-effectiveness of Therapy]] | [[Rat-bite fever future or investigational therapies|Future or Investigational Therapies]]
[[Rat-bite fever medical therapy|Medical Therapy]] | [[Rat-bite fever primary prevention|Prevention]]  | [[Rat-bite fever cost-effectiveness of therapy|Cost-effectiveness of Therapy]] | [[Rat-bite fever future or investigational therapies|Future or Investigational Therapies]]


==Antimicrobial therapy==
==Related Chapters==
 
* [[Streptobacillus moniliformis]]
:* Streptococcus moniliformis treatment<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
* [[Spirillum minus]]
 
::* (1) '''Migratory arthropathy and arthritis'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (2) '''Diarrhea, (especially kids) liver or spleen abscess'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (3) '''Undifferentiated fever'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (4) '''Endocarditis, myocarditis, pericarditis (cardiac)'''
:::* Preferred regimen: [[Penicillin]] 20 MU/day IV divided q4h. Optimal duration recommendation for infective endocarditis is 4 weeks.
:::* Alternative regimen: [[Cephalosporins]]-[[Ceftriaxone]] {{or}} [[Clindamycin]] {{or}} [[Erythromycin]] {{or}} [[Chloramphenicol]] {{and}} [[Streptomycin]].
 
::* (5) '''Meningitis, brain abscess'''
:::* Preferred regimen: [[Penicillin]] 20 MU/day IV divided q4h.
:::* Alternative regimen: [[Cephalosporins]]-[[Ceftriaxone]] {{or}} [[Clindamycin]] {{or}} [[Erythromycin]] {{or}} [[Chloramphenicol]] {{and}} [[Streptomycin]].
 
::* (6) '''Anemia'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (7)''' Pneumonia'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (8) '''Amnionitis''' (pregnancy)
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
::* (9) '''Renal abscess'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.
 
* '''Prevention'''
 
::* Eradication of rats.
::* Pasteurize milk.
::* Avoid contaminated water.
::* Use gloves when handling rodents in lab (can also be carried by hamsters and other laboratory rodents).
::* If bitten: oral [[Penicillin]] (2 gs) for 3 days may be beneficial.
 
==References==
 
{{reflist|2}}
 
==External Links==
*[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5351a2.htm Case report of fatal incidence in the USA]
*http://www.cdc.gov/rat-bite-fever/
 
{{Bacterial diseases}}
[[hr:Vrućica štakorskog ugriza]]
[[it:febbri da morso di ratto]]
[[ja:鼠咬症]]


[[Category:Disease]]
[[Category:Disease]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Infectious diseases]]
[[Category:Infectious diseases]]
[[Category:Overview complete]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Latest revision as of 19:21, 6 August 2015

This page is about clinical aspects of the disease. For microbiologic aspects of specific causative organisms: Template:Seealso Template:Seealso

Rat-bite fever Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Rat-bite fever from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Rat-bite fever On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Rat-bite fever

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Rat-bite fever

CDC on Rat-bite fever

Rat-bite fever in the news

Blogs on Rat-bite fever

Directions to Hospitals Treating Rat-bite fever

Risk calculators and risk factors for Rat-bite fever

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Spirillum minus rat bite fever; spirochaeta morsus minus; spirochaeta muris; sokosho; sodoku.

Overview

Historical Perspective

Pathophysiology

Epidemiology and Demographics

Risk Factors

Causes

Differentiating Rat-bite fever from other Diseases

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Prevention | Cost-effectiveness of Therapy | Future or Investigational Therapies

Related Chapters

Retrieved from "https://www.wikidoc.org/index.php?title=Rat-bite_fever&oldid=1127824"