Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case report
Abstract Background Rat bite fever (RBF) is a rare zoonosis transmitted from rodents to humans through bites and scratches. However, diagnosis and treatment of atypical clinical cases can be challenging. Case presentation Herein, we report an atypical case of RBF with unilateral knee joint infection...
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BMC
2025-03-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-10575-5 |
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| author | Mengping Gao Shaojin Zhong Guibin Han Duncai Kuang Changying Yun Cegang Fu |
| author_facet | Mengping Gao Shaojin Zhong Guibin Han Duncai Kuang Changying Yun Cegang Fu |
| author_sort | Mengping Gao |
| collection | DOAJ |
| description | Abstract Background Rat bite fever (RBF) is a rare zoonosis transmitted from rodents to humans through bites and scratches. However, diagnosis and treatment of atypical clinical cases can be challenging. Case presentation Herein, we report an atypical case of RBF with unilateral knee joint infection caused by Streptobacillus moniliformis. Streptobacillus moniliformis was isolated from the knee synovial fluid of the patient via microbiological culture and metagenomic next-generation sequencing (mNGS). After treatment with antibiotics and arthroscopic surgery, the patient reported symptom alleviation and was subsequently discharged home. This is the first reported detection of intraarticular histopathological changes caused by Streptobacillus moniliformis during knee arthroscopy. Conclusions In atypical cases, importantly, clinical healthcare professionals should promptly obtain microbiological culture results. When culture is negative, 16S ribosomal RNA gene polymerase chain reaction (16S rRNA PCR) or mNGS can be considered for identification, with inquiring about the patient’s disease history, including any contact with rodents. Surgical interventions, such as arthroscopy, may be included in treatment. Streptobacillus moniliformis infection should be considered when considerable fibrous connective tissue and capillary proliferation are observed under arthroscopic guidance. |
| format | Article |
| id | doaj-art-e23b5a6100a14edba81f7db4dd038c1d |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-e23b5a6100a14edba81f7db4dd038c1d2025-08-20T03:05:56ZengBMCBMC Infectious Diseases1471-23342025-03-012511710.1186/s12879-025-10575-5Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case reportMengping Gao0Shaojin Zhong1Guibin Han2Duncai Kuang3Changying Yun4Cegang Fu5Department of Pharmacy, Haikou Orthopedic and Diabetes Hospital, Haikou Orthopedic and Diabetes Hospital of Shanghai Sixth People’s HospitalDepartment of Pharmacy, Affiliated Haikou Hospital of Xiangya Medical College, Central South UniversityDepartment of Orthopedics, Affiliated Haikou Hospital of Xiangya Medical College, Central South UniversityDepartment of Orthopedics, Haikou Orthopedic and Diabetes Hospital, Haikou Orthopedic and Diabetes Hospital of Shanghai Sixth People’s HospitalDepartment of Laboratory, Haikou Orthopedic and Diabetes Hospital, Haikou Orthopedic and Diabetes Hospital of Shanghai Sixth People’s HospitalDepartment of Orthopedics, Haikou Orthopedic and Diabetes Hospital, Haikou Orthopedic and Diabetes Hospital of Shanghai Sixth People’s HospitalAbstract Background Rat bite fever (RBF) is a rare zoonosis transmitted from rodents to humans through bites and scratches. However, diagnosis and treatment of atypical clinical cases can be challenging. Case presentation Herein, we report an atypical case of RBF with unilateral knee joint infection caused by Streptobacillus moniliformis. Streptobacillus moniliformis was isolated from the knee synovial fluid of the patient via microbiological culture and metagenomic next-generation sequencing (mNGS). After treatment with antibiotics and arthroscopic surgery, the patient reported symptom alleviation and was subsequently discharged home. This is the first reported detection of intraarticular histopathological changes caused by Streptobacillus moniliformis during knee arthroscopy. Conclusions In atypical cases, importantly, clinical healthcare professionals should promptly obtain microbiological culture results. When culture is negative, 16S ribosomal RNA gene polymerase chain reaction (16S rRNA PCR) or mNGS can be considered for identification, with inquiring about the patient’s disease history, including any contact with rodents. Surgical interventions, such as arthroscopy, may be included in treatment. Streptobacillus moniliformis infection should be considered when considerable fibrous connective tissue and capillary proliferation are observed under arthroscopic guidance.https://doi.org/10.1186/s12879-025-10575-5Streptobacillus moniliformisRat bite feverPurulent arthritisKnee arthroscopyMetagenomic next-generation sequencing |
| spellingShingle | Mengping Gao Shaojin Zhong Guibin Han Duncai Kuang Changying Yun Cegang Fu Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case report BMC Infectious Diseases Streptobacillus moniliformis Rat bite fever Purulent arthritis Knee arthroscopy Metagenomic next-generation sequencing |
| title | Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case report |
| title_full | Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case report |
| title_fullStr | Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case report |
| title_full_unstemmed | Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case report |
| title_short | Atypical rat bite fever associated with knee joint infection in a Chinese patient: a case report |
| title_sort | atypical rat bite fever associated with knee joint infection in a chinese patient a case report |
| topic | Streptobacillus moniliformis Rat bite fever Purulent arthritis Knee arthroscopy Metagenomic next-generation sequencing |
| url | https://doi.org/10.1186/s12879-025-10575-5 |
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