• Der Unfallchirurg · Sep 2018

    [Infections after bite wounds : For example rat bite fever due to Streptobacillus moniliformis].

    • Herbert Hof, Rudolf Binder, Christian Schäfer, Madeleine Stuber, Andreas Licht, Iris Bozenhardt-Stavrakidis, and Konrad Bode.
    • Labor, SLK Kliniken, Am Gesundbrunnen 20-26, 74078, Heilbronn, Deutschland. herbert.hof@labor-limbach.de.
    • Unfallchirurg. 2018 Sep 1; 121 (9): 764-768.

    AbstractRat bite fever due to Streptobacillus moniliformis induces typical but not pathognomonic clinical signs, such as local purulent wound infection followed by maculopapular exanthema, myalgia as well as purulent joint infections. Severe complications, such as osteomyelitis and endocarditis are possible. it seems that this infection is rarely diagnosed but this infection could be much more common because the final diagnostic proof is difficult to achieve. Firstly, the culture of these bacteria is critical because the bacteria are fastidious and secondly the exact differentiation of the isolates is hardly possible by standard laboratory methods. Modern techniques such as mass spectroscopy (MALDI-TOF) and molecular biology allow a precise clarification. Surgical cleansing of infection sites in combination with a rational antibiotic therapy, for example with beta-lactam antibiotics, are generally able to cure the infection if treatment is started early enough. In addition, vaccinations, for example against tetanus and rabies have to be considered in this situation as for all other bite wound infections.

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