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==Treatment==
==Treatment==
[[Rat-bite fever medical therapy|Medical therapy]] | [[Rat-bite fever surgery|Surgical options]] | [[Rat-bite fever primary prevention|Primary prevention]]  | [[Rat-bite fever secondary prevention|Secondary prevention]] | [[Rat-bite fever cost-effectiveness of therapy|Financial costs]] | [[Rat-bite fever future or investigational therapies|Future therapies]]
[[Rat-bite fever medical therapy|Medical therapy]] | [[Rat-bite fever surgery|Surgical options]] | [[Rat-bite fever primary prevention|Primary prevention]]  | [[Rat-bite fever secondary prevention|Secondary prevention]] | [[Rat-bite fever cost-effectiveness of therapy|Financial costs]] | [[Rat-bite fever future or investigational therapies|Future therapies]]
== Epidemiology and Demographics ==
Rat-bite fever is rare in the United States. However, since RBF is not a notifiable disease, exact numbers of cases are not known.
Rat-bite fever is not a reportable disease in any state. However, unexplained deaths or critical illnesses or rare diseases of public health importance may be reportable in certain states. If RBF is suspected in a severe illness or death but a diagnosis has not been made, physicians can consider reporting the case to their state or local health department.
Since Rat-bite fever is not a reportable disease, trends in disease incidence are not available. However, recent reports have highlighted the potential risk for RBF among persons having contact with rats at home or in the workplace.


== Risk Factors ==
== Risk Factors ==

Revision as of 16:06, 7 February 2012

Rat-bite fever
ICD-10 A25
ICD-9 026
DiseasesDB 32803 Template:DiseasesDB2
MeSH D011906

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

Overview

Historical Perspective

Pathophysiology

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Causes

Differentiating Rat-bite fever

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History and Symptoms | Physical Examination | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics

Treatment

Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies

Risk Factors

Persons who are at risk for infection include those who work with animals in labs or pet stores and persons living in dwellings infested with wild rats. People who have pet rats may also be at risk for infection.

Symptoms

Initial symptoms are non-specific and include fever, chills, myalgias, arthralgias, headache, vomiting. Patients may develop a maculopapular rash on the extremities or septic arthritis 2-4 days after fever onset. The incubation period typically ranges from 2-10 days. If not appropriately treated, severe manifestations may include endocarditis, myocarditis, meningitis, pneumonia and sepsis. In rare cases, death occurs.

Diagnosis

The findings of rash, fever, and arthritis in individuals with a history of rat exposure suggest the diagnosis of Rat-bite fever.

Diagnosis of S. moniliformis is typically made by isolating the organism from blood or synovial fluid. Specific media and incubation conditions should be used. In the absence of a positive culture, identification of pleomorphic gram-negative bacilli in appropriate specimens supports a preliminary diagnosis. Since the organism does not grow in artificial media, diagnosis of S. minus is made by identifying characteristic spirochetes in appropriate specimens using darkfield microscopy or differential stains.

Risk Stratification and Prognosis

Severe complications such as endocarditis, myocarditis, pericarditis, pneumonia, meningitis, and focal organ abscesses may occur. Rapidly fatal cases have been reported. Untreated RBF is associated with a mortality of 7%-10%. With appropriate antimicrobial therapy, the clinical course may be shortened and severe complications may be prevented.

Treatment

Responds to penicillin antibiotics or where allergic to this erythromycin or tetracyclines for repectively streptobacillary or spirillary infections.

Prevention

Whilst obviously preventable by staying away from rodents, otherwise hands and face should be washed after contact and any scratches both cleaned and antiseptics applied.

References

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/ratbitefever_g.htm

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