Rat-Bite Fever Due to <i>Streptobacillus moniliformis</i> in a Patient without Bite History: an Unexpected Cause of Consciousness Disturbance

Abstract

Rat-bite fever (RBF) is a zoonotic disease caused by direct contact with rats harboring Streptobacillus moniliformis, Streptobacillus notomytis, or Spirillum minus (1,2). Few studies have reported RBF cases. Therefore, the incidence of RBF is not well understood in Japan. The mortality rate is approximately 10% in undertreated RBF cases (1,3). Of the 3 bacterial causes, S. moniliformis infection typically presents as a triad of relapsing fever, polyarthralgia, and skin rash along with severe diseases, including pneumonia, meningitis, and endocarditis (3). Generally, a history of rat bite is an important clue for RBF diagnosis. However, we encountered a case of RBF caused by S. moniliformis infection without rat bite.