Migratory Polyarthralgias and Skin Rash: Rat Bite Fever with a Positive Anti-Cyclic Citrullinated Peptide

Rat bite fever is a rare, underdiagnosed disease caused by in the United States, and is typically characterized by leukocytosis, elevated C-reactive protein, migratory polyarthralgias, and pustular skin rash. Rat bite fever is frequently misdiagnosed as either a viral illness or a rheumatologic dise...

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Bibliographic Details
Published in:Mayo Clinic proceedings. Innovations, quality & outcomes quality & outcomes, 2020-04, Vol.4 (2), p.223-227
Main Authors: Shadrin, Ilya Y, Albitar, Ahmad A H, Paim, Ana Catarina, Issa, Meltiady, Wilson, Walter R
Format: Article
Language:English
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Case Report
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Summary:Rat bite fever is a rare, underdiagnosed disease caused by in the United States, and is typically characterized by leukocytosis, elevated C-reactive protein, migratory polyarthralgias, and pustular skin rash. Rat bite fever is frequently misdiagnosed as either a viral illness or a rheumatologic disease and carries a high mortality risk if untreated. We report the first case of rat bite fever associated with positive anti-cyclic citrullinated peptide. The patient initially presented with low back pain and developed a pustular rash as well as severe asymmetric polyarthralgias. Blood cultures turned positive for and the patient completed a 4-week course of antibiotics for presumed septic arthritis.
ISSN:2542-4548
DOI:10.1016/j.mayocpiqo.2019.11.004