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Rat-bite fever is an acute, febrile human illness caused by bacteria and transmitted by rodents, in most cases, which is passed from rodent to human by the rodent's urine or mucous secretions. It is a rare disease and caused by two specific types of bacteria.The condition responds to penicillin, and where allergies to the medication occur, erythromycin or tetracyclines can be used instead.[1]


In terms of the presentation of Rat-bite fever we find it includes sudden high temperature fever with rigors, vomiting, headaches, and painful joints. A red, bumpy rash develops in about 75 percent of individuals. [2]


Among the complications for Rat-bite fever we find, endocarditis, fulminant sepsis, meningitis, liver abscess and adrenal gland failure.[1]


Two types of Gram-negative, facultatively anaerobic bacteria can cause the infection, they are Spirillosis and Streptobacillosis.[3]


Rat-bite fever is a zoonotic disease.[4] It can be directly transmitted by rats, gerbils, and mice, which are the vectors, to humans by either a bite or scratch or it can be passed from rodent to rodent.[5]


This condition is diagnosed by detecting the bacteria in skin, blood, joint fluid, or lymph nodes. Blood antibody tests may also be used.[6] To get a proper diagnosis for rat-bite fever, different tests are run depending on the symptoms being experienced.[1]

Differential diagnosis

The differential diagnosis for Rat-bite fever is as follows:Lyme disease, Leptospirosis, Brucellosis, Rocky Mountain spotted fever and S. aureus infection.[7]


Treatment with antibiotics is the same for both types of infection. The condition responds to penicillin, and where allergies to it occur, erythromycin or tetracyclines are used.[1][8]


Although cases of RBF have been reported all over the world, the majority of cases that have been documented are caused by S. moniliformis primarily in the United States, where approximately 200 cases have been identified and reported.[2][9][10]


  1. 1.0 1.1 1.2 1.3 Gupta, Mohit; Bhansali, Rakesh Kumar; Nagalli, Shivaraj; Oliver, Tony I. (2024). "Rat-Bite Fever". StatPearls. StatPearls Publishing. Archived from the original on 2024-03-28. Retrieved 2024-06-05.
  2. 2.0 2.1 Elliott, Sean P. (January 2007). "Rat Bite Fever and Streptobacillus moniliformis". Clinical Microbiology Reviews. 20 (1): 13–22. doi:10.1128/CMR.00016-06. ISSN 0893-8512. Retrieved 26 June 2024.
  3. "Rat-bite fever: MedlinePlus Medical Encyclopedia".
  4. Loridant, Severine; Jaffar-Bandjee, Marie-Christine; Scola, Bernard La (2011-02-04). "Shell Vial Cell Culture as a Tool for Streptobacillus moniliformis "Resuscitation"". The American Journal of Tropical Medicine and Hygiene. 84 (2): 306–307. doi:10.4269/ajtmh.2011.10-0466. ISSN 0002-9637. PMC 3029187. PMID 21292904.
  5. Vanderpool, Matthew R. (September 27, 2007). "Environmental Core Training: Zoonosis, Vector Disease, Poisonous Plants & Basic Control Measures". Tulane University. Archived from the original on April 6, 2022. Retrieved November 18, 2018.
  6. MedlinePlus Encyclopedia: Rat-bite fever
  7. "Orphanet: Rat-bite fever". Archived from the original on 15 June 2024. Retrieved 13 June 2024.
  8. "Rat-Bite Fever - Rat-Bite Fever". Merck Manual Professional Edition. Retrieved 23 June 2024.
  9. Wullenweber, Michael (1995). "Streptobacillus moniliformis-a zoonotic pathogen. Taxonomic considerations, host species, diagnosis, therapy, geographical distribution". Laboratory Animals. 29 (1): 1–15. doi:10.1258/002367795780740375. ISSN 0023-6772. PMID 7707673.
  10. Freels, Liane K.; Elliott, Sean P. (April 2004). "Rat Bite Fever: Three Case Reports and a Literature Review". Clinical Pediatrics. 43 (3): 291–295. doi:10.1177/000992280404300313. ISSN 0009-9228. PMID 15094956. S2CID 46260997.