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      Acute Tetraplegia Caused by Rat Bite Fever in Snake Keeper and Transmission of Streptobacillus moniliformis

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          Abstract

          We report acute tetraplegia caused by rat bite fever in a 59-year old man (snake keeper) and transmission of Streptobacillus moniliformis. We found an identical characteristic bacterial pattern in rat and human samples, which validated genotyping-based evidence for infection with the same strain, and identified diagnostic difficulties concerning infection with this microorganism.

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          Approved and novel strategies in diagnostics of rat bite fever and other Streptobacillus infections in humans and animals.

          Tobias Eisenberg, Christa Ewers, Jörg Rau … (2016)
          Rat bite fever (RBF), a worldwide occurring and most likely under-diagnosed zoonosis caused by Streptobacillus moniliformis, represents the most prominent disease of Streptobacillus infections. Recently, novel members have been described, from which a reservoir in rats and other animal species and a zoonotic potential can be assumed. Despite regularly published case reports, diagnostics of RBF continues to represent a 'diagnostic dilemma', because the mostly applied 16S rRNA sequence analysis may be uncertain for proper pathogen identification. Virtually nothing is known regarding prevalence in humans and animal reservoirs. For a realistic assessment of the pathogen's spread, epidemiology and virulence traits, future studies should focus on the genomic background of Streptobacillus. Full genome sequence analyses of a representative collection of strains might facilitate to unequivocally identify and type isolates. Prevalence studies using selective enrichment mechanisms may also enable the isolation of novel strains and candidate species of this neglected group of microorganisms.
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            Rat-bite fever septic arthritis: illustrative case and literature review.

            C Dendle, T Korman, I Woolley (2006)
            Rat-bite fever is a rare zoonotic infection caused by Streptobacillus moniliformis or Spirillum minus, which is characterised by fever, rash and arthritis. The arthritis has previously been described as non-suppurative and isolation of the organism from synovial fluid as very uncommon. This article reports a case of septic arthritis diagnosed as rat-bite fever when the organism was cultured from synovial fluid and reviews another 15 cases of S. moniliformis septic arthritis reported in the worldwide literature since 1985. Articles were included in this review if S. moniliformis was cultured from synovial fluid. Of the published cases, 88% presented with polyarthritis, affecting small and large joints although two had monoarticular hip sepsis. Fever was present in 88%, rash in 25% and 56% had extra-articular features. Synovial fluid analysis revealed high cell counts in all cases (mean 51,000 x 10(9)/l) with a predominance of polymorphonuclear leucocytes, and organisms were found on Gram stain in only 50%. Penicillin was used for treatment in 56% of cases and surgery was required in 30%. All patients recovered. Rat-bite fever arthritis can be suppurative and attempts should be made to isolate the organism from synovial fluid. The diagnosis should be considered when there is arthritis and a high synovial fluid cell count but no apparent organism, especially when the patient has had contact with rats.
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              Phylogenetic and comparative genomics of the family Leptotrichiaceae and introduction of a novel fingerprinting MLVA for Streptobacillus moniliformis

              Tobias Eisenberg, Ahmad Fawzy, Werner Nicklas … (2016)
              Background The Leptotrichiaceae are a family of fairly unnoticed bacteria containing both microbiota on mucous membranes as well as significant pathogens such as Streptobacillus moniliformis, the causative organism of streptobacillary rat bite fever. Comprehensive genomic studies in members of this family have so far not been carried out. We aimed to analyze 47 genomes from 20 different member species to illuminate phylogenetic aspects, as well as genomic and discriminatory properties. Results Our data provide a novel and reliable basis of support for previously established phylogeny from this group and give a deeper insight into characteristics of genome structure and gene functions. Full genome analyses revealed that most S. moniliformis strains under study form a heterogeneous population without any significant clustering. Analysis of infra-species variability for this highly pathogenic rat bite fever organism led to the detection of three specific variable number tandem analysis loci with high discriminatory power. Conclusions This highly useful and economical tool can be directly employed in clinical samples without laborious prior cultivation. Our and prospective case-specific data can now easily be compared by using a newly established MLVA database in order to gain a better insight into the epidemiology of this presumably under-reported zoonosis. Electronic supplementary material The online version of this article (doi:10.1186/s12864-016-3206-0) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): April 2017
                Volume: 23
                Issue: 4
                Pages: 719-721
                Affiliations
                [1]Hessian State Laboratory, Giessen, Germany (T. Eisenberg, A. Fawzy);
                [2]Centre Hospitalier Universitaire de Tours, Tours, France (S. Poignant, Y. Jouan, L. Mereghetti, A. Guillon);
                [3]Université François Rabelais, Tours (S. Poignant, Y. Jouan, L. Mereghetti, A. Guillon);
                [4]Cairo University, Giza, Egypt (A. Fawzy);
                [5]Justus-Liebig-University, Giessen (A. Fawzy, C. Ewers);
                [6]German Cancer Research Center, Heidelberg, Germany (W. Nicklas)
                Author notes
                Address for correspondence: Antoine Guillon, Centre Hospitalier Regional Universitaire de Tours, 2 Blvd Tonnelle, Tours 37044, France; email: antoine.guillon@ 123456univ-tours.fr
                Article
                Publisher ID: 16-1987
                DOI: 10.3201/eid2304.161987
                PMC ID: 5367424
                PubMed ID: 28322713
                SO-VID: 1bb2b6c9-263f-4b23-bf0b-1e1760693d80
                History
                Categories
                Subject: Research Letter
                Subject: Research Letter
                Subject: Acute Tetraplegia Caused by Rat Bite Fever in Snake Keeper and Transmission of Streptobacillus moniliformis

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: acute tetraplegia,rat bite fever,snake keeper,transmission,streptobacillus moniliformis,bacteria,zoonoses,variable number tandem repeat analysis,multilocus variant analysis,snakes,reptiles,rats,pcr,species specificity,france
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: acute tetraplegia, rat bite fever, snake keeper, transmission, streptobacillus moniliformis, bacteria, zoonoses, variable number tandem repeat analysis, multilocus variant analysis, snakes, reptiles, rats, pcr, species specificity, france

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