Systemic vasculitis following an unreported rat bite

• Published in: Annals of the rheumatic diseases Vol. 62; no. 7; pp. 605 - 606
• Main Authors: Tattersall, R S, Bourne, J T
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.07.2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Animals; Ankle; Anti-Inflammatory Agents - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis; Arthritis, Gouty - drug therapy; Arthritis, Gouty - microbiology; Biological and medical sciences; Bites and stings; Care and treatment; Causes of; Complications and side effects; Cyclophosphamide - therapeutic use; Diseases of the osteoarticular system; Drug Therapy, Combination; Fever; Fingers & toes; Gangrene; Gout; Humans; Ischemia - drug therapy; Ischemia - microbiology; Lesson of the Month; Male; Medical sciences; Methylprednisolone - therapeutic use; Microscopy; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Physical Therapy Modalities; rat bite; Rat-Bite Fever - diagnosis; Rat-Bite Fever - drug therapy; Rheumatism; Vasculitis; Vasculitis - drug therapy; Vasculitis - microbiology; United Kingdom; Juxtaarticular disease; Skin disease; Rat; Gout; Diseases of the osteoarticular system; Bite; Hyperuricemia; Vasculitis; Disease of the hand; Bacteria; Adult; Complication; Upper limb; Diagnosis; Human; Streptobacillus moniliformis; Rodentia; Clinical form; Metabolic diseases; Inflammation; Uric acid; Hand; Case study; Infection; Vertebrata; Mammalia; Treatment; Bacteriosis
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.62.7.605

There is abrupt onset of fever remitting in 2-5 days and recurring three days later with the onset of other symptoms. 1 Commonly these are centrifugal rash with erythematous macules, petechial haemorrhages, 2 and discharging pustules with an asymmetrical arthralgia/arthritis and sore throat. 1 Less commonly, there is desquamation, 1 abscesses, endocarditis, pericardial effusion, and suppurative arthritis. 3 Our patient developed polyarticular gout during this illness. Synovial biopsy is also of limited diagnostic use, showing typical non-specific changes of acute and chronic inflammation associated with septic arthritis. 2 RBF is a rare cause of systemic vasculitis which is not notifiable and therefore underrecognised.