Thomas Kolman, MD; Noor Bhatti, MPH; Shruti Narayan, MA; Akorfa Adobor, BS; Samuel Fischer, MD; Pinky Jha, MD
WMJ. 2026;125(3):418-420. Published August 11, 2026.
ABSTRACT
Introduction: Rat bite fever is a rare zoonotic illness that presents with nonspecific symptoms. Rapid identification and treatment are essential to reduce morbidity or mortality.
Case Presentation: A 39-year-old male presented to the emergency department with severe headache and arthralgias. His history was notable for multiple bites and scratches from pet rats. He was admitted for further evaluation after meeting systemic inflammatory response syndrome (SIRS) criteria for sepsis. A meningitis workup was unrevealing. He was treated for presumed rat bite fever with amoxicillin and discharged in improved condition. Several days later, his blood culture grew Streptobacillus moniliformis. His symptoms resolved with appropriate antibiotic therapy.
Discussion: Prompt recognition and management are necessary to avoid complications of rat bite fever. A thorough history is crucial to identify uncommon exposures when initial workup is unrevealing.
Conclusions: This report describes a rare, culture-confirmed case of rat bite fever. Because this disease is not nationally reportable, it may be more prevalent than currently recognized and should remain in the differential diagnosis for patients with nonspecific symptoms and known rodent exposure.