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Mathé P, Schmidt K, Schindler V, Fawzy A, Schultze T, Voll RE, Pauli D, Popova M, Schauer F, Eisenberg T. Streptobacillus moniliformis and IgM and IgG Immune Response in Patient with Endocarditis 1. Emerg Infect Dis 2024; 30:608-610. [PMID: 38407252 PMCID: PMC10902545 DOI: 10.3201/eid3003.230917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
We describe a case of endocarditis caused by Streptobacillus moniliformis bacteria, a known cause of rat-bite fever, in a 32-year-old woman with pet rats in Germany. The patient had a strong serologic response, with high IgM and IgG titers. Serologic analysis is a promising tool to identify S. moniliformis bacterial infection.
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Van Hooste WLC. Rat bite fever: some comments on a case report review. Acta Clin Belg 2023; 78:1-2. [PMID: 35037839 DOI: 10.1080/17843286.2022.2028113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Wim L C Van Hooste
- Occupational Health Services, Mediwet Vzw, External Service for Prevention and Protection, Gent, Belgium
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3
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Mahesh A, Padrao EMH, Randhawa R, Oommen C, Romo J, Illindala R, Anyimadu H. A Rodential Reckoning: A Case Report and Systematic Review of Streptobacillary Endocarditis. Autops Case Rep 2023; 13:e2023423. [PMID: 37101553 PMCID: PMC10124564 DOI: 10.4322/acr.2023.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/18/2023] [Indexed: 04/28/2023]
Abstract
Introduction Endocarditis is a rare, often fatal complication of rat bite fever caused by Streptobacillus moniliformis. Only 39 cases have been reported (including this case) as of 2022. We describe a case and aim to perform this entit's first systematic literature review. Methods We performed a systematic review in CENTRAL, EMBASE, MEDLINE, SciELO, and LILACS. The terms used were terms used were (but not limited to) rat bite fever, Streptobacillus moniliformis, Spirillum minus, and endocarditis. We included all abstracts and articles with patients with echocardiographic or histologic-proven endocarditis. In case of discordance, a third reviewer was involved. Our protocol was submitted to PROSPERO (CRD42022334092). We also performed searches for studies on the reference list of included articles. Results We retrieved 108 and included 36 abstracts and articles. A total of 39 patients (including our report) were identified. The mean age was 41.27, and 61.5% were males. The most common findings were fever, murmur, arthralgias, fatigue, splenomegaly, and rash. Underlying heart disease was present in 33%. Exposure to rats was noted in 71.8% of patients, with 56.4% recalling a rat bite. Anemia was seen in 57%, leukocytosis in 52%, and elevated inflammatory markers in 58% that had lab work performed. The mitral valve was most affected, followed by the aortic, tricuspid, and pulmonary valves. Surgical intervention was required in 14 (36%) cases. Of those, 10 required valve replacement. Death was reported in 36% of cases. Unfortunately, the literature available is limited to case series and reports. Conclusion Our review allows clinicians to suspect better, diagnose, and manage Streptobacillary endocarditis.
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Affiliation(s)
- Ashwin Mahesh
- University of Connecticut, Department of Medicine, Farmington, CT, USA
| | | | - Ravneet Randhawa
- University of Connecticut, Department of Medicine, Farmington, CT, USA
| | - Christi Oommen
- University of Connecticut, Department of Medicine, Farmington, CT, USA
| | - Johanna Romo
- University of Connecticut, Department of Medicine, Farmington, CT, USA
| | | | - Henry Anyimadu
- Hartford HealthCare, Department of Infectious Disease, Hartford, CT, USA
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Fawzy A, Giel AS, Fenske L, Bach A, Herden C, Engel K, Heuser E, Boelhauve M, Ulrich RG, Vogel K, Schmidt K, Eisenberg T. Development and validation of a triplex real-time qPCR for sensitive detection and quantification of major rat bite fever pathogen Streptobacillus moniliformis. METHODS IN MICROBIOLOGY 2022; 199:106525. [PMID: 35738493 DOI: 10.1016/j.mimet.2022.106525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/19/2022]
Abstract
Streptobacillus (S.) moniliformis is the most important pathogen causing rat bite fever (RBF) worldwide. This zoonotic pathogen is understudied mainly due to difficulties in culturing S. moniliformis as a fastidious microorganism. Therefore, advances in molecular detection techniques are highly needed, especially with regard to the widespread availability of real-time quantitative (q) PCR in laboratories. In this study, we aimed to develop a qPCR for the identification of Streptobacillus species and quantification of S. moniliformis in clinical samples, especially those derived from tissue samples of animal origin. We optimized a previously described PCR protocol in order to develop a qPCR, which can detect different Streptobacillus species with high specificity and is simultaneously able to quantitate S. moniliformis in different clinical matrices. The qPCR exhibited a limit of detection (LOD) of 21 copies/reaction representing ~4-5 streptobacilli, while the limit of quantification (LOQ) was 2.1 × 103 copies/reaction. It was also more sensitive than conventional PCR by two orders of magnitude and proved to have a substantial agreement (Kappa 0.74) compared to it with a superior detection rate in 374 samples from wild rats, laboratory rats and animals from holdings of wild-trapped rats. To conclude, the qPCR described in this study is an important molecular tool that is able to quantify S. moniliformis in tissue samples of animal origin. It represents a suitable tool for future establishment and evaluation of other molecular assays that are highly needed for a better understanding of epidemiology and pathophysiology of RBF. In experimental studies, it will also be useful for titration purposes since the quantification of the organism using classical plate counting technique is problematic and inaccurate.
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Affiliation(s)
- Ahmad Fawzy
- Cairo University, Faculty of Veterinary Medicine, Department of Medicine and Infectious Diseases, Giza Square, 12211, Egypt; Hessian State Laboratory, 35392 Giessen, Germany.
| | | | - Linda Fenske
- Hessian State Laboratory, 35392 Giessen, Germany
| | - Alexa Bach
- Institute of Veterinary Pathology, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Christiane Herden
- Institute of Veterinary Pathology, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | | | - Elisa Heuser
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, 17493 Greifswald, Insel Riems, Germany; German Centre for Infection Research (DZIF), Partner site Hamburg-Lübeck-Borstel-Riems, 17493 Greifswald, Insel Riems, Germany
| | - Marc Boelhauve
- Fachhochschule Südwestfalen, Fachbereich Agrarwirtschaft, 59494 Soest, Germany
| | - Rainer G Ulrich
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, 17493 Greifswald, Insel Riems, Germany; German Centre for Infection Research (DZIF), Partner site Hamburg-Lübeck-Borstel-Riems, 17493 Greifswald, Insel Riems, Germany
| | - Klaus Vogel
- German Cancer Research Center, Microbiological Diagnostics, 69126 Heidelberg, Germany
| | - Katja Schmidt
- German Cancer Research Center, Microbiological Diagnostics, 69126 Heidelberg, Germany
| | - Tobias Eisenberg
- Hessian State Laboratory, 35392 Giessen, Germany; Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig-University Giessen, 35392 Giessen, Germany
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5
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Abstract
CONTEXT Rat bite fever is a rare disease with a challenging differential diagnosis. The zoonosis has a potentially lethal course in a vulnerable population (children and low socioeconomic class) and a commonly available standard therapy (penicillin). This case report review outlines common epidemiological and clinical factors to improve clinical awareness and timely response to therapeutic actions. METHODS A systematic literature review was conducted in the PubMed database looking for English language European case reports of rat bite fever from 2000 to 2021. RESULTS In 17 out of 20 selected cases, the condition of the index patient was identified as an infectious syndrome. Thanks to the almost omnisensitive susceptibility pattern of Streptobacillus moniliformis, timely antibiotic administration prevented an unfavorable outcome in all these cases. However, in the three remaining cases, the initial diagnoses were arthritis (on autoimmune basis and gout) and viral syndrome. Due to delayed antibiotic administration, one case suffered persistent harm, while the other two cases encountered prolonged illness. CONCLUSION AND RECOMMENDATIONS Rat bite fever is a diagnosis that can be easily missed from both a clinical and a microbiological point of view. As such, rat bite fever becomes part of the differential diagnosis whenever a patient presents with a fever syndrome after being in contact with rodents. In the case of persistent fever, blood culture sampling should be performed even in the absence of a systemic inflammatory response. A bacterial 16S ribosomal RNA PCR on blood or joint aspiration (cultures) is an even more sensitive diagnostic test. Since most transmissions occurred in a domestic setting, keeping rats as pets cannot be recommended.
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Affiliation(s)
- Marie Coessens
- Microbiology Department AZ Delta Roeselare, Roeselare, Belgium
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Adams SH, Mahapatra R. Rat bite fever with osteomyelitis and discitis: case report and literature review. BMC Infect Dis 2021; 21:479. [PMID: 34039283 PMCID: PMC8153095 DOI: 10.1186/s12879-021-06172-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rat bite fever (RBF) is a rare systemic febrile illness transmitted by rats. Streptobacillus moniliformis is a pleomorphic Gram-negative bacillus which is the usual etiologic organism for rat bite fever in the United States. CASE PRESENTATION Here we present a case of rat bite fever complicated by vertebral osteomyelitis and discitis. The patient revealed an exposure history of being bitten by pet rats. The patient's symptoms dramatically improved with a six-week course of cephalexin therapy. CONCLUSIONS It is important to obtain a thorough zoonotic exposure history and maintain rat bite fever in the differential when considering potential causes of discitis and osteomyelitis.
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Affiliation(s)
- Steven H Adams
- Upstate Medical University, 750 E Adams St, Syracuse, NY, 13210, USA
| | - Rahul Mahapatra
- Department of Medicine, Division of Infectious Diseases, Upstate Medical University, Syracuse, NY, USA. .,Upstate Infectious Diseases Associates, 725 Irving Ave, Suite 311, Syracuse, NY, 13210, USA.
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Kelly AJ, Ivey ML, Gulvik CA, Humrighouse BW, McQuiston JR. A real-time multiplex PCR assay for detection of the causative agents of rat bite fever, Streptobacillus moniliformis and zoonoticStreptobacillus species. Diagn Microbiol Infect Dis 2021; 100:115335. [PMID: 33618204 DOI: 10.1016/j.diagmicrobio.2021.115335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/24/2021] [Accepted: 01/28/2021] [Indexed: 12/17/2022]
Abstract
Rat bite fever (RBF) caused by Streptobacillus moniliformis has been described as a diagnostic challenge. While it has a favorable prognosis with treatment, timely diagnosis is hindered by the lack of culture-free identification methods. Here we present a multiplex real-time PCR assay that detects the zoonotic Streptobacillus spp. as well as differentiate the primary causative agent of RBF, Streptobacillus moniliformis. The performance of this assay was evaluated using mock clinical specimens for blood, serum, and urine. Analytical sensitivity was determined to be 3-4 genome equivalents (GE)/µl for the zoonotic Streptobacillus spp. target, and 1-2 GE/µl for the S. moniliformis specific target. The assay correctly detected only the intended targets with no cross-reactivity identified. The pathogen was detected in all spiked matrices and not detected in the negative non-spiked specimens. This rapid diagnostic assay may permit quicker diagnosis of RBF patients.
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Affiliation(s)
- Aubree J Kelly
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Melissa L Ivey
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher A Gulvik
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ben W Humrighouse
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John R McQuiston
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Khatib MY, Elshafei MS, Mutkule DP, Shabana AM, Chengamaraju D, Nashwan AJ. Rat Bite Fever: The First Case Report from Qatar. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e925647. [PMID: 33038206 PMCID: PMC7556352 DOI: 10.12659/ajcr.925647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patient: Male, 37-year-old Final Diagnosis: Rat bite fever Symptoms: Acute gastroenteritis • fever • headache • loose stools • vomiting Medication: — Clinical Procedure: — Specialty: Critical Care Medicine • Dermatology • Infectious Diseases • Public Health
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Affiliation(s)
- Mohamad Y Khatib
- Department of Critical Care, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Moustafa S Elshafei
- Department of Critical Care, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Dnyaneshwar P Mutkule
- Department of Critical Care, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Amr M Shabana
- Department of Critical Care, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Dinesh Chengamaraju
- Department of Critical Care, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Abdulqadir J Nashwan
- Department of Critical Care, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar.,University of Calgary in Qatar (UCQ), Doha, Qatar
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Fawzy A, Rau J, Riße K, Schauerte N, Geiger C, Blom J, Imirzalioglu C, Falgenhauer J, Bach A, Herden C, Eisenberg T. Streptobacillus felis, a member of the oropharynx microbiota of the Felidae, isolated from a tropical rusty-spotted cat. Antonie van Leeuwenhoek 2020; 113:1455-1465. [PMID: 32776203 PMCID: PMC7415334 DOI: 10.1007/s10482-020-01454-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/22/2020] [Indexed: 11/26/2022]
Abstract
Streptobacillus felis is a fastidious microorganism and a novel member of the potentially zoonotic bacteria causing rat bite fever. Since its description, this is the second isolation of S. felis in a diseased member of the Felidae. Interestingly, the strain from this study was isolated from a zoo held, rusty-spotted cat (Prionailurus rubiginosus), with pneumonia, thereby indicating a possible broader host range in feline species. A recent preliminary sampling of domestic cats (Felis silvestris forma catus) revealed that this microorganism is common in the oropharynx, suggesting that S. felis is a member of their normal microbiota. Due to unawareness, fastidiousness, antibiotic sensitivity and lack of diagnostics the role of S. felis as a cat and human pathogen might be under-reported as with other Streptobacillus infections. More studies are necessary to elucidate the role of S. felis in domestic cats and other Felidae in order to better estimate its zoonotic potential.
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Affiliation(s)
- Ahmad Fawzy
- Faculty of Veterinary Medicine, Department of Medicine and Infectious Diseases, Cairo University, Cairo, Egypt
- Department of Veterinary Medicine, Hessian State Laboratory (LHL), Schubertstr. 60, 35392, Giessen, Germany
| | - Jörg Rau
- Chemical and Veterinary Analysis Agency Stuttgart, Schaflandstr. 3/2, 70736, Fellbach, Germany
| | - Karin Riße
- Department of Veterinary Medicine, Hessian State Laboratory (LHL), Schubertstr. 60, 35392, Giessen, Germany
| | - Nicole Schauerte
- Frankfurt Zoo, Bernhard-Grzimek-Allee 1, 60316, Frankfurt, Germany
| | - Christina Geiger
- Frankfurt Zoo, Bernhard-Grzimek-Allee 1, 60316, Frankfurt, Germany
| | - Jochen Blom
- Bioinformatics and Systems Biology, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 58, 35392, Giessen, Germany
| | - Can Imirzalioglu
- Institute for Medical Microbiology, Justus Liebig University Giessen, Schubertstr. 81, 35392, Giessen, Germany
| | - Jane Falgenhauer
- Institute for Medical Microbiology, Justus Liebig University Giessen, Schubertstr. 81, 35392, Giessen, Germany
| | - Alexa Bach
- Institute of Veterinary Pathology, Justus-Liebig-University Giessen, Frankfurter Str. 96, 35392, Giessen, Germany
| | - Christiane Herden
- Institute of Veterinary Pathology, Justus-Liebig-University Giessen, Frankfurter Str. 96, 35392, Giessen, Germany
| | - Tobias Eisenberg
- Department of Veterinary Medicine, Hessian State Laboratory (LHL), Schubertstr. 60, 35392, Giessen, Germany.
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig-University Giessen, 35392, Giessen, Germany.
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Eisenberg T, Heydel C, Prenger-Berninghoff E, Fawzy A, Kling U, Akimkin V, Semmler T, Mühldorfer K, Kämpfer P, Blom J, Ewers C. Streptobacillus canis sp. nov. isolated from a dog. Int J Syst Evol Microbiol 2020; 70:2648-2656. [PMID: 32209168 DOI: 10.1099/ijsem.0.004086] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
From a phlegmon in a dog an aerobic and facultatively anaerobic, indole-, oxidase- and catalase-negative, non-motile bacterium was isolated in 2019 in Germany that stained Gram-negative and showed a pleomorphic, rod-shaped, non-spore-forming appearance. Based on the results of 16S rRNA gene sequence analyses, strain IHIT1603-19T was assigned to the genus Streptobacillus with sequence similarities of 98.6, 98.0, 97.9, 97.1 and 94.4 % to the type strains of Streptobacillus felis, Streptobacillus notomytis, Streptobacillus ratti, Streptobacillus moniliformis and Streptobacillus hongkongensis, respectively. Strain IHIT1603-19T could also clearly be differentiated from other Streptobacillus species by rpoB, groEL and recA gene, nucleotide and amino acid sequence analyses as well as by core genome phylogeny. Regarding DNA-DNA relatedness, strain IHIT1603-19T demonstrated an average nucleotide identity of 83.00 and 82.28 % compared to S. felis 131000547T and S. moniliformis DSM 12112T, respectively. Chemotaxonomic and physiological data of strain IHIT1603-19T were in congruence with other closely related members of the family Leptotrichiaceae, represented by highly similar enzyme profiles and fatty acid patterns. MALDI-TOF MS analysis also proved suitable in unequivocally discriminating strain IHIT1603-19T from all currently described taxa of the genus Streptobacillus. On the basis of these data, we propose the novel species Streptobacillus canis sp. nov. with the type strain IHIT1603-19T (=DSM 110501T=CCUG 74118T=CIP 111795T). The G+C content of the DNA of the type strain is 26.6 mol%, genome size is 1.60 Mbp.
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Affiliation(s)
- Tobias Eisenberg
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig-University Giessen, 35392 Giessen, Germany.,Hessian State Laboratory, 35392 Giessen, Germany
| | - Carsten Heydel
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Ellen Prenger-Berninghoff
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Ahmad Fawzy
- Cairo University, Faculty of Veterinary Medicine, Department of Medicine and Infectious Diseases, Giza Square 12211, Egypt.,Hessian State Laboratory, 35392 Giessen, Germany
| | - Ulrike Kling
- Hessian State Laboratory, 35392 Giessen, Germany
| | - Valerij Akimkin
- Chemical and Veterinary Investigatory Office Stuttgart, 70702 Fellbach, Germany
| | - Torsten Semmler
- Robert Koch Institute, Microbial Genomics, 13353 Berlin, Germany
| | - Kristin Mühldorfer
- Department of Wildlife Diseases, Leibniz Institute for Zoo and Wildlife Research, 10315 Berlin, Germany
| | - Peter Kämpfer
- Institute of Applied Microbiology, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Jochen Blom
- Bioinformatics and Systems Biology, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig-University Giessen, 35392 Giessen, Germany
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Pena E, Jordão S, Simões MJ, Oleastro M, Neves I. A rare cause of vertebral osteomyelitis: the first case report of rat-bite fever in Portugal. Rev Soc Bras Med Trop 2019; 53:e20190328. [PMID: 31859955 PMCID: PMC7083378 DOI: 10.1590/0037-8682-0328-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/24/2019] [Indexed: 11/22/2022] Open
Abstract
Rat-bite fever is a rarely diagnosed illness caused by Streptobacillus moniliformis . Although this disease is distributed worldwide, there have been few cases reported in Europe. Here, we report a case of vertebral osteomyelitis and sternoclavicular septic arthritis caused by S. moniliformis in a Portuguese patient previously bitten by a rat. Laboratory diagnosis was performed using molecular identification. This is the first case report of rat-bite fever in Portugal. The case described here serves as a reminder for physicians to consider this diagnosis in patients who have developed fever syndromes after being in contact with rodents.
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Affiliation(s)
- Eduarda Pena
- Matosinhos Local Health Unit, Infectious Diseases Department, Matosinhos, Porto, Portugal
| | - Sofia Jordão
- Matosinhos Local Health Unit, Infectious Diseases Department, Matosinhos, Porto, Portugal
| | - Maria João Simões
- National Health Institute Doutor Ricardo Jorge (INSA), Infectious Diseases Department, Lisboa, Portugal
| | - Mónica Oleastro
- National Health Institute Doutor Ricardo Jorge (INSA), Infectious Diseases Department, Lisboa, Portugal
| | - Isabel Neves
- Matosinhos Local Health Unit, Infectious Diseases Department, Matosinhos, Porto, Portugal
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12
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Zhang WW, Hu YB, He GX, Zhou Y, Hong L, Ding JG. Rat bite fever caused by Streptobacillus moniliformis infection in a Chinese patient. BMC Infect Dis 2019; 19:637. [PMID: 31315559 PMCID: PMC6637549 DOI: 10.1186/s12879-019-4281-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 07/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rat bite fever (RBF), a severe infectious disease, can result from transmission of the pathogen Streptobacillus moniliformis (S. moniliformis) by rat bite. RBF diagnosis can be overlooked. CASE PRESENTATION We present a case of RBF in a Chinese patient who was infected with S. moniliformis in mainland China. Meta-next generation sequencing (mNGS) was used to identify potential pathogens and detected S. moniliformis genome sequences in the pustular sample in less than 72 h. Then the diagnosis was validated by polymerase chain reaction analysis. Despite having severe RBF with complications, this 54-year-old male patient was successfully cured with penicillin as a result of timely pathogen-based diagnosis. CONCLUSIONS Physicians should inquire about recent rat exposure and consider the possibility of RBF when a patient develops unexplained fever and rashes. mNGS is a new diagnostic technology and may identify RBF pathogens even when blood culture results are negative.
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Affiliation(s)
- Wei-Wei Zhang
- Department of Infectious Diseases, The Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325200, People's Republic of China
| | - Yi-Bing Hu
- Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Guo-Xin He
- Department of Infectious Diseases, The Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325200, People's Republic of China
| | - Yu Zhou
- Department of Infectious Diseases, The Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325200, People's Republic of China
| | - Liang Hong
- Department of Infectious Diseases, The Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325200, People's Republic of China.
| | - Ji-Guang Ding
- Department of Infectious Diseases, The Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325200, People's Republic of China.
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Michel V, Ulber C, Pöhle D, Köpke B, Engel K, Kaim U, Fawzy A, Funk S, Fornefett J, Baums CG, Eisenberg T. Clinical infection in house rats (Rattus rattus) caused by Streptobacillus notomytis. Antonie van Leeuwenhoek 2018; 111:1955-1966. [PMID: 29671179 DOI: 10.1007/s10482-018-1085-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
Rat bite fever is an under-reported, under-diagnosed emerging zoonosis with worldwide distribution. Besides Spirillum minus, Streptobacillus moniliformis is the major causative microorganism although it usually colonises rats without any clinical signs. A group of house rats (Rattus rattus) kept in a zoo exhibition for educational purposes suffered from neurological signs including disorientation, torticollis, stall walking, ataxia and death. Gross pathological and histo-pathological examinations of the investigated rats revealed high-grade otitis interna et media, from which Streptobacillus notomytis was isolated in pure culture or as the predominant microorganism. This case series underlines a previously expressed hypothesis that R. rattus might be naturally colonised with S. notomytis, whereas the traditional rat bite fever organism, S. moniliformis, might be restricted to the Norway rat (Rattus norvegicus). However, the general paucity of Streptobacillus isolates, especially from their respective animal hosts, precludes definitive proof of these host tropisms. This is the first report of S. notomytis detection outside Asia and Australia and the first evidence for its role as a facultative pathogen in house rats.
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Affiliation(s)
- Viktoria Michel
- Naturschutz-Tierpark Görlitz e. V., Zittauer Str. 43, 02826, Görlitz, Germany
| | - Claudia Ulber
- Landesuntersuchungsanstalt für das Gesundheits- und Veterinärwesen Sachsen (LUA), Jägerstr. 8/10, 01099, Dresden, Germany
| | - Dietrich Pöhle
- Landesuntersuchungsanstalt für das Gesundheits- und Veterinärwesen Sachsen (LUA), Jägerstr. 8/10, 01099, Dresden, Germany
| | - Beate Köpke
- Landesuntersuchungsanstalt für das Gesundheits- und Veterinärwesen Sachsen (LUA), Jägerstr. 8/10, 01099, Dresden, Germany
| | - Katharina Engel
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany
| | - Ute Kaim
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany
| | - Ahmad Fawzy
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany.,Faculty of Veterinary Medicine, Department of Medicine and Infectious Diseases, Cairo University, Giza Square, 12211, Egypt.,Institut für Hygiene und Infektionskrankheiten der Tiere, Justus-Liebig-Universität, Frankfurter Str. 89, 35392, Giessen, Germany
| | - Sophie Funk
- Veterinärmedizinische Fakultät, Zentrum für Infektionsmedizin, Institut für Bakteriologie und Mykologie, Universität Leipzig (IBML), An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Juliane Fornefett
- Veterinärmedizinische Fakultät, Zentrum für Infektionsmedizin, Institut für Bakteriologie und Mykologie, Universität Leipzig (IBML), An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Christoph Georg Baums
- Veterinärmedizinische Fakultät, Zentrum für Infektionsmedizin, Institut für Bakteriologie und Mykologie, Universität Leipzig (IBML), An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Tobias Eisenberg
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany. .,Institut für Hygiene und Infektionskrankheiten der Tiere, Justus-Liebig-Universität, Frankfurter Str. 89, 35392, Giessen, Germany.
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