Streptobacillus moniliformis septic arthritis: a clinical entity distinct from rat-bite fever?

Streptobacillus moniliformis is a zoonotic agent associated with rodent contacts. Although it is more commonly
reported to cause rat-bite fever with reactive arthritides, it can also lead to pyogenic infection of the joints.

Rat bites were known to result in human diseases for more than 2000 years. The causative agent of rat-bite fever
named Streptomyces muris ratti was first isolated in 1914 by Schottuller [1]. It was a pleomorphic Gram-negative
bacillus that colonizes the nasopharnyx of rats and other rodents [2]. Various names have been associated with this
organism [3], and its nomenclature was finally changed to Streptobacillus moniliformis, which is the name used
today, when the bacterium was isolated from a laboratory worker by Levaditi in 1925 [4]. The streptobacillary rat-bite
fever is a systemic disease typically presenting with fever, skin rash, and arthralgia, with minimal inflammatory
reaction over the bitten site [5]. Oral ingestion of the organism causes the disease Haverhill fever (also known as
erythema arthriticum epidemicum), which is clinically similar to rat-bite fever and was associated with three reported
large scale outbreaks [6-8]. Complications of the infection include endocarditis, pneumonia and metastatic
abscesses [5]. With increased urbanization, the disease has become less common.
However, a report from the
Centers for Disease Control and Prevention in 2005 describing two rapidly fatal cases of rat-bite fever in
previously healthy adults illustrates that rat-bite fever is still an important zoonotic infection after
occupational and recreational exposure to rats, and S. moniliformis-related infections may be
re-emerging [9].

BMC Infectious Diseases 2007, 7:56