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Haverhill fever; streptobacillary fever; streptobacillosis (rat-bite fever)
Etiology: Streptobacillus moniliformis
Epidemiology: rat bite
Clinical manifestations:
1) fever, arthralgias, myalgias, headache
2) maculopapular rash over palms, soles, extremities
3) rash may be purpuric
4) rash may desquamate
5) myalgias
6) arthritis (50%), ankle, knee, wrist
7) recurrent fevers in some cases
* images [2]
Management:
- ceftriaxone -> amoxicillin
General
rat-bite fever
References
- arrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 93
- Giorgiutti S, Lefebvre N.
Images in Clinical Medicine: Rat Bite Fever.
N Engl J Med 2019; 381:1762. Oct 31, 2019
PMID: 31665580
https://www.nejm.org/doi/full/10.1056/NEJMicm1905921