Streptobacillus moniliformis septic arthritis: a clinical entity distinct from rat-bite fever?

Wang, Teresa K. F.; Wong, Samson S. Y.

doi:10.1186/1471-2334-7-56

Cited by 51 publications

(41 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Case reports have also described pericardial effusion, septic arthritis, suppurative polyarthritis, and systemic vasculitis. Streptobacillary endocarditis has often been described as a complication and carries a mortality rate of 53% (2,3). In our patient, Streptobacillus moniliformis was eventually isolated from the righthip synovial fluid, which is consistent with previous reports of septic arthritis (2, 3).…”

Section: Rbf Is a Bacterial Infection Caused By Either Streptobacillusupporting

confidence: 90%

Septic Arthritis and Concern for Osteomyelitis in a Child with Rat Bite Fever

Flannery

Akinboyo

et al. 2013

J Clin Microbiol

View full text Add to dashboard Cite

bRat bite fever is a rare infection usually caused by Streptobacillus moniliformis. A case of septic arthritis and possible osteomyelitis as sequelae of rat bite fever in a pediatric patient is described. CASE REPORTA 22-month-old male presented during the summer of 2011 to the emergency department of the Alfred I. duPont Hospital for Children with 2 days of upper respiratory tract symptoms followed by 5 days of fever, malaise, and a gradually worsening rash on his upper and lower extremities, including his palms and soles. The rash began to blister, and the toddler became irritable, prompting evaluation. Given his prodrome and rash, the patient was initially thought to have a viral syndrome, such as coxsackievirus. He was admitted for intravenous hydration and pain control. Initial vital signs included mild hypertension, tachycardia, and a fever to 38.0°C.Physical examination revealed a toddler in moderate distress with a tender, erythematous, pustular rash scattered on his feet (Fig. 1), ankles, and hands. No joint swelling or tenderness was initially noted; however, due to patient anxiety, examination was difficult. Initial laboratory results were unremarkable, including a white blood cell (WBC) count of 10,200/l, a hemoglobin concentration of 10.9 g/dl, and a platelet count of 217,000/l, with normal differential values, electrolytes, and urinalysis results. Blood and left-foot pustule fluid were sent for cultures. Over the next few days, his fevers persisted in the setting of a worsening rash and pain. The patient had reportedly been walking less prior to admission, which was attributed to the painful lesions on his feet, but on day 5, he refused to bear any weight and on exam was noted to have pain when his right-hip range of motion was examined. Repeat blood work revealed a WBC count of 18,100/l, a hemoglobin concentration of 10.0 g/dl, a platelet count of 523,000/l, and a neutrophilic predominance. Inflammatory markers revealed a C-reactive protein concentration of 5.4 mg/dl and an erythrocyte sedimentation rate of 94 mm/h. A repeat blood culture was drawn, a lumbar puncture was performed, and an infectious disease specialist was consulted for further evaluation. An ultrasound of the right hip was performed, which found a joint effusion, and the child was started on vancomycin and ceftriaxone for empirical bacterial coverage. Caretakers rereviewed the patient's initial history, and a physical and further discussion revealed that the family had two pet rats. Rat bite fever (RBF) quickly entered the differential.The patient was taken emergently to the operating room due to concern for septic joint, where right-hip joint aspiration revealed a cloudy, green fluid, which was sent for a cell count and culture. Given the clinical scenario and appearance of the fluid, formal open irrigation and debridement of the joint were performed. After 6 liters of irrigation, a sterile Jamshidi needle was used to aspirate the proximal metaphysis of the right femur, and the bone sample was sent for culture. The Gram stain of ...

show abstract

Section: Rbf Is a Bacterial Infection Caused By Either Streptobacillusupporting

confidence: 90%

Septic Arthritis and Concern for Osteomyelitis in a Child with Rat Bite Fever

Flannery

Akinboyo

et al. 2013

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…Case reports have also described pericardial effusion, septic arthritis, suppurative polyarthritis and systemic vasculitis. In our patient, S monoformis was eventually isolated from the repeat right ankle synovial fluid aspirate via 16S rRNA PCR, which is consistent with previous reports of septic arthritis 2 3…”

Section: Discussionsupporting

confidence: 91%

Septic arthritis secondary to rat bite fever: a challenging diagnostic course

Budair¹,

Goswami

Dhukaram

2014

BMJ Case Reports

View full text Add to dashboard Cite

show abstract

“…This highlights the importance of appropriate diagnosis. However, even with the right treatment, when the clinical response to antibiotics alone is suboptimal (for example, because of poor antibiotic penetration into the abscess), surgical intervention is required for local drainage to remove any infections and to reduce the bacterial load in the abscess (11). Several drainages were necessary in our patient to enhance treatment.…”

Section: Case Reportmentioning

confidence: 93%

Streptobacillus moniliformis as the Causative Agent in Spondylodiscitis and Psoas Abscess after Rooster Scratches

et al. 2008

View full text Add to dashboard Cite

We report a case of Streptobacillus moniliformis spondylodiscitis accompanied by a psoas abscess in an 80-year-old man scratched by a rooster. S. moniliformis was identified from abscess fluid by use of 16S rRNA gene sequencing. After 18 weeks of antimicrobial therapy, the clinical condition of the patient improved. CASE REPORTIn 2005, an 80-year-old farmer was admitted to the university hospital of Clermont-Ferrand, France, for treatment of deterioration of his general health and inflammatory syndrome. In 1993, he had undergone total left hip replacement; in 2000, his right hip was also replaced. At the time of his admission, he was undergoing no treatment and had no known allergy. His symptoms had begun 1 week earlier, a few days after a rooster had scratched his left hand; he experienced shaking chills without fever and back pain that irradiated to both legs on awakening. The pain gradually disappeared.On admission, physical examination showed no specific signs. Laboratory investigations revealed functional renal insufficiency. His leukocyte count was 19 ϫ 10 9 /liter, his neutrophil count was 18 ϫ 10 9 /liter, the serum level of C-reactive protein (CRP) was 488 mg/liter (a normal level is Ͻ5 mg/liter), the serum level of fibrinogen was 8.9 g/liter (a normal level is 2 to 4 g/liter), and the level of procalcitonine was 13 ng/ml (a normal level is Ͻ0.5 ng/ml). Four blood specimens were inoculated into the Bactec blood culture system (Becton Dickinson

show abstract

Streptobacillus moniliformis septic arthritis: a clinical entity distinct from rat-bite fever?

Abstract: Background: Streptobacillus moniliformis is a zoonotic agent associated with rodent contacts. Although it is more commonly reported to cause rat-bite fever with reactive arthritides, it can also lead to pyogenic infection of the joints.

Cited by 51 publications

References 35 publications

Septic Arthritis and Concern for Osteomyelitis in a Child with Rat Bite Fever

Septic Arthritis and Concern for Osteomyelitis in a Child with Rat Bite Fever

Septic arthritis secondary to rat bite fever: a challenging diagnostic course

Streptobacillus moniliformis as the Causative Agent in Spondylodiscitis and Psoas Abscess after Rooster Scratches

Contact Info

Product

Resources

About