Rat-bite fever
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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
- (1) Migratory arthropathy and arthritis (joints)
- Preferred regimen: Penicillin G IV uncomplicated disease—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 (gastrointestinal)
- Preferred regimen: Penicillin G IV uncomplicated disease—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: Penicillin G IV uncomplicated disease—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 IE is 4 wks.
- 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. Optimal duration recommendation for IE is 4 wks.
- Alternative regimen: Cephalosporins-Ceftriaxone OR Clindamycin OR Erythromycin OR Chloramphenicol AND Streptomycin.
- (6) Anemia
- Preferred regimen: Penicillin G IV uncomplicated disease—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: Penicillin G IV uncomplicated disease—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: Penicillin G IV uncomplicated disease—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: Penicillin G IV uncomplicated disease—2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral Amoxicillin OR Penicillin Vk complete 14 days.
External Links
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