Rat-Bite Fever Case 3

The following was information obtained from the patient.

"I was afflicted with a sudden onset of 104^oF fever last year (2000), which was thought initially to be a “stomach flu” since it was accompanied by nausea and vomiting.  Needless to say it was accompanied by initially severe lower back, sciatica pain, which progressed, into bilateral and unilateral arthritis so painful that I could barely move.  I went to my internist who was stumped, and was then sent to a rhematologist who felt it was the onset of rheumatoid arthritis and proceeded to treat me as such.  Steroids did nothing.  I am a nurse and cynical by nature. I went to an infectious disease specialist.  He did a battery of tests, which were inconclusive. Laboratory test results included a false positive RPR, elevated WBC blood cell count. Cultures for organisms from joint fluid grew nothing.

I have lots of pets, which was mentioned to the Infectious Disease specialist, including pet rats.  My husband felt it had something to do with them.  I called my vet to ask about this, they said no, I tried to contact Univ. of Penn Vet Dept, with no success.

My affliction continued for two months, arthritis worsening and was transient at times. I developed non-infectious hepatitis, anemia, platelet count of 300,000 and fever of a least 100^oF every day with night sweats.  My internist sent me to the emergency room at Jefferson Hospital due to severe abdominal pain and nausea.  The resident there did tests took my history and brought up the possibility of RBF.  I took this information to my physicians. The infectious disease specialist sent joint fluid and blood cultures to be tested for this.  They came back negative. In the mean time he treated me with TCN 2000mg per day for 14days. There was rapid reversal of my symptoms."

What differences and similarities did this case have when compared to the other two cases?

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