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Streptobacillus moniliformis is a gram-negative bacillus and is one of two bacteria that causes Rat Bite Fever. Aside from Rat Bite Fever, it is also sometimes referred to as Streptobacilliosis, streptobacillary fever, Haverhill fever, and epidemic arthritic erythema. In Japan, it is known as “sodoku”, however, most cases in Asia are caused by the second bacteria, Spirillum minus. In the United States, Rat Bite Fever, commonly abbreviated as RBF, has only been caused by Streptobacillus moniliformis. This bacteria is found in the normal respiratory flora of rodents and is excreted in urine, oral, nasal, or conjunctival secretions. It is spread to humans through bites, scratches, or contact of the previously mentioned secretions with broken skin. It can also be spread by ingesting contaminated food or drink.

The symptoms of RBF typically begin around 3-10 days after contact with the bacteria but might take as long as three weeks and include fever, vomiting, headache, and muscle pain. Joint pain or swelling has also been reported in about 50% of cases and a rash occurs in around 75% of cases which appears on the hands and feet around 2-4 days after the fever begins. Complications of RBF might include abscesses inside the body, hepatitis, nephritis, pneumonia, meningitis, and infections involving the heart such as endocarditis, myocarditis, or pericarditis. Anybody who works with or around rats, has rats in their homes as pets or kept as food for other pets, or lives in a rat-infested area is at risk for RBF. Children under five and elderly adults with weaker immune systems are at an even higher risk for infection.

The best way to avoid Rat Bite Fever is by avoiding direct contact with rodents, places with rodent infestations, or any areas where rodents might be present. If you have regular contact with rodents then you should wear gloves when handling them or cleaning their cages, avoid touching your face or mouth after handling, and making sure to always wash your hands afterward with soap and warm water for at least 20 seconds.

While Rat Bite Fever is generally susceptible to several antibiotics, treatment typically includes 7 days of penicillin G administered intravenously followed by oral penicillin. If the patient is allergic to penicillin then doxycycline or streptomycin are the primary alternative choices. With early treatment, symptoms should begin improving rather quickly, however, without treatment, Rat Bite Fever has been known to cause death in around 10% of known cases.

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Rat Bite Fever is generally susceptible to several antibiotics including penicillins, cephalosporins, carbapenems, aztreonam, clindamycin, erythromycin, nitrofurantoin, bacitracin, doxycycline, tetracycline, teicoplanin, and vancomycin.

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The best way to avoid Rat Bite Fever is by avoiding direct contact with rodents, places with rodent infestations, or any areas where rodents might be present.

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People who live in or visit rat infested areas.

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People with pet rats or other rodents in their home, or who might keep feeder rats for other pets.

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Anybody who works with rats or rodents including people who work at animal research laboratories and pet store workers.

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Symptoms include fever, chills, vomiting, headaches, and muscle pain.

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Streptobacillus moniliformis causes Rat Bite Fever. It's also sometimes referred to as Streptobacilliosis, Streptobacillary fever, Haverhill fever, and epidemic arthritic erythema.

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Anybody who has been bitten or scratched by a rat or other rodents.

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Streptobacillus moniliformis under a light microscope.

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Joint pain or swelling has also been reported in around 5 in 10 cases and a rash occurs in around 3 out of 4 cases.

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Scanning electron micrograph of Streptobacillus moniliformis

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If you work in a pet store use gloves when handling rodents or cleaning their cages, avoiding touching your face or mouth after handling, and always wash your hands afterward with soap and warm water.

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The recommended treatment for RBF is typically 7 days of penicillin G administered intravenously, followed by oral penicillin.

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Children under five and elderly adults are at a higher risk due to their weaker immune systems.

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Complications of RBF might include abscesses in the body, hepatitis, nephritis, pneumonia, meningitis, and infections involving the heart.

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If the patient is allergic to penicillin, doxycycline or streptomycin are the primary alternative choices.