Rat Bite Fever Project
Microbiology Spring 2011/ FMCC
http://ratbitefeverproject.wordpress.com
The Amazing Rat
Introduction to Emilii
Rat facts
数独
Soduko
Discovered in Japan
Soduko
Discovered in 1908 in urban areas with poor
sanitation in far east Japan
Disease caused by the bacteria spirillum
minus; a bacteria naturally carried by rats
Transmission of illness through the skin by the
bite of a rat
Mortality rate 10%
S. minus ; is a genus of gram-negative spiral and curved
bacteria including one species S. minus which is
pathogenic for rats and the cause of Soduko in Japan.
Soduko
Spiral with 2-3 turns
lophotrichous
Cell end blunt or pointed
Diameter 0.2µm Length 3-5µm
Requires host cell for cultivation
Motile
Best observed in blood stained with Wright’s stain
Soduko is not considered a major disease because it
requires a human be bitten by a wild rat or other
animal that has been colonized by the bacterium.
Symptoms
 Relapsing fever that may subside then spontaneously return;
this condition can persist for several months
 History of a rat bite that heals, the spontaneously returns as
an ulcer that starts to break down the skin
 Draining lymph nodes that swell and become painful
 Body temperature rises over 104◦ F followed by an incubation
period between 5-10 days
Child suffers from rat bite
Rash caused by S. minus, infant was bit by a rat
Living With Rats
Haverhill Fever
Haverhill Fever
 Discovered in 1926 in Haverhill, Mass; 86 individuals became
ill from drinking milk that was contaminated with the bacteria
Streptobacillus moniliformis , this epidemic was the first
documented on the illness
 Acute febrile illness
 Transmitted through rat urine, or feces through a cut or an
open wound
 People who live in rat infested homes are prone to the
condition and laboratory workers who work with lab rats
 The illness is naturally carried in the nose and throats of rats.
Streptobacillus moniliformis
Gram stain smear of S. moniliformis on a blood agar medium
Haverhill fever
Slow growing requiring 3 or more days for isolation
Growth appears as “puff balls "on agar
Gram negative bacillus tend to stain poorly
Measures 1-5µm in length
Appearance of filaments with bulbar swellings looks like string of beads
Organism optimal growth is microaerophillic
Fastidious and requires media supplemented with blood
Pleomorphic/ capable of assuming different shapes
Acid produced from glucose medium
Non-motile
Non-encapsulated
Oxidase and catalase negative
Symptoms
 High fever and chills
 Headache
 Myalgia and joint pain
 Nausea and vomiting
 Generalized rash resembling measles occurring on the extremities especially the
hands and feet
 Enlarged lymph nodes
 Sore throat
Generalized rash from Haverhill Fever
Blisters caused by the bacteria S. moniliformis
Hemorrhagic vesicles on the first and third toes of a patient
Petechial and purpuric lesions
Hemorrhagic pustule
6 year old with S. moniliformis
S. minus
S.moniliformis
Requires host cell for cultivation
Cannot grow on artificial medium
Slow growing requiring 3 or more days for isolation
Fastidious and requires media supplemented with
blood
Lophotrichous; Spiral with 2-3 turns
Growth appears as “puff balls "on agar, and the
appearance of filaments with bulbar swellings looks
like string of beads
Gram negative; Best observed in blood
stained with Wright’s stain
Gram negative tends to stain poorly
Measures 0.2µm Length 3-5µm
Measures 1-5µm in length
Organism optimal growth is micro-aerophillic
Motile
Non-motile
Cell end blunt or pointed
Pleomorphic/ capable of assuming different shapes
Acid produced from glucose medium
Treatment with
Penicillin
 Penicillin natural or
semisynthetic used as
an anti-bacterial
antibiotic derived from
the strains of fungi of
the genus of penicillium
these fungi exert a
bacteriostatic effect on
susceptible bacteria by
interfering with the
final stages of the
synthesis of
peptidoglycan
 Both cases of Rat Bite
Fever can be treated
with penicillin
Treatment with
Tetracycline
 Tetracycline inhibits
bacteria by blocking
protein synthesis
 Tetracycline crosses the
membranes of bacteria
and accumulates in the
cytoplasm
 Binds to a single unit on
the ribosome and blocks
RNA interaction which
stops the lengthening of
the protein chain
 Both cases of Rat Bite
Fever can be treated
with tetracycline
Fatal Cases
There were two deaths in 2003 caused from rat bite
fever.
The victims were two healthy women; one from
Florida the other from Washington State; both
women died within 12 hours of being hospitalized.
The victim in Florida worked in a pet store and was
bit by a rat and became infected with S. minus
The victim in Washington State owned 9 pet rats, she
became infected with S. moniliformis
Prevention
When handling rats the CDC suggests
Wearing protective gloves
Practice safe hand washing techniques after
handling rats or coming in contact with rat urine
or feces
Avoid hand to mouth contact with rats
If you are bitten by a rat clean and disinfect
wound then seek prompt medical treatment
If you suspect a rat infestation in your home call
an exterminator in to help remedy infestation.
Cases of Rat Bite Fever
We have provided information on two
separate patients with Rat Bite Fever
Your job is to diagnosis the patients with
either Haverhill Fever, or Soduko from the
information we have provided in our
presentation.
Make a Diagnosis
• Patient #1
• Patient #2
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8 year old boy
Fever for 4 days accompanied by vomiting for 2
days followed by a sore throat.
The boy developed a headache, rash on his
hands and feet; with complaints of myagias and
neck pain. The onset of ambulation problems,
pain and dizziness were also noted.
Recent purchase of a rat from a pet store, the
rat died on the first day of illness.
Blood pressure 113/59 pulse 94, respiratory
rate 24, temperature 38.4◦C
Head eyes, ears, nose and throat appeared
normal
Urinalysis normal
Nasopharyngeal, rectal viral, aerobic bacteria
cultures were negative
Gram stain of cerebrospinal fluid was negative.
The diagnosis is?
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35 year old, white male
The wound healed.
12 days later, there was an onset of
erythema, swelling and tenderness at the
site of the bite.
24 hours later, lymphangitis set in extending
up the left arm with onset of chills and
fever.
On a peripheral blood smear stained with
Wright’s stain showed an extracellular spiral
organism.
500 mg. of penicillin was taken orally for 7
days; all symptoms resolved 24 hours after
starting therapy.
The diagnosis is?
Carefully prepared by
Erika Lindsay and Kalley Lee
References
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Baltimore: Williams & Wilkins, 1994. Print.
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