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Rat bite fever is caused by the bacteria Streptobacillus moniliformis. Rat bite fever is an acute febrile illness accompanied by a skin rash. Those affected get a morbilliform rash over the extremities, particularly the hands and feet. They may also have painful swelling and restricted movement of wrist and knee joints. Signs of systemic infection may also be present including chills and headache. The bacteria can be isolated from blood and synovial fluid of inflamed joints. Most cases of this are from bites of wild or lab rats. Occasionally, mice, squirrels, weasels, dogs, and cats can transmit the disease by biting or scratching. The disease can also be caused by drinking rat excrement-contaminated milk. However, the disease is then called Haverhill fever. Rat bite fever is seen worldwide but more in crowded cities with poor sanitation. Treatment is with antibiotics such as amoxicillin/clavulonic acid or doxycycline. Source: Blackwell's Underground Clinical Vignettes USMLE Step I, Microbiology Vol II, 3rd ed. Bonnie Tam
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