Open Access Open Access  Restricted Access Subscription Access

Rat Bite Fever Resembling Rheumatoid Arthritis


Affiliations
1 Department of Internal Medicine, Memorial University, St. John’s, NL, A1B 3V6, Canada
2 Disciplines of Medicine and Laboratory Medicine, Memorial University, St. John’s, NL, A1B 3V6, Canada
3 Department of Medicine, Memorial University, St. John’s, NL, A1B 3V6, Canada
4 Eastern Health, St. John’s, NL, A1C 5B8, Canada
 

Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.
User
Notifications
Font Size

Abstract Views: 88

PDF Views: 0




  • Rat Bite Fever Resembling Rheumatoid Arthritis

Abstract Views: 88  |  PDF Views: 0

Authors

Ripa Akter
Department of Internal Medicine, Memorial University, St. John’s, NL, A1B 3V6, Canada
Paul Boland
Department of Internal Medicine, Memorial University, St. John’s, NL, A1B 3V6, Canada
Peter Daley
Disciplines of Medicine and Laboratory Medicine, Memorial University, St. John’s, NL, A1B 3V6, Canada
Proton Rahman
Department of Medicine, Memorial University, St. John’s, NL, A1B 3V6, Canada
Nayef Al Ghanim
Eastern Health, St. John’s, NL, A1C 5B8, Canada

Abstract


Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.