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Haverhill Fever

Erythema Arthriticum Epidemicum

Haverhill fever is a term used to describe an infection by streptobacillus moniliformis, the causative agent of rat bite fever. Apart from a different mode of infection (ingestion of food, water or milk contaminated by rodent feces), the clinical presentation is almost identical - fever, headaches, joint pain and myalgia are most prominent signs. Advanced microbiological methods are necessary to make the diagnosis.


Presentation

Haverhill fever, named after an outbreak of the disease in Haverhill, Massachusetts in 1926, through contamination of milk, is a bacterial infection caused by streptobacillus moniliformis. This microorganism is more frequently known as the causative agent of rat bite fever, occurring after the bite of a rodent (most commonly a rat) [1] [2] [3] [4]. Due to the similar etiology, Haverhill fever and rat bite fever have the same clinical presentation, although different modes of infection are described [1] [5]. Haverhill fever, considered to be a very rare infection, appears after ingestion of food products (turkey, water, and milk are mentioned) contaminated by rodent feces, with an incubation period of 2-10 days [5] [6] [7]. Fever, headaches, fatigue, myalgia, migratory polyarthralgia (involving the hands, wrists, elbows and knees in most cases), vomiting, weight loss, diarrhea, and chills are clinical hallmarks of this infection [3] [7] [8]. It should be noted that Haverhill fever may be distinguished from rat bite fever by more severe episodes of vomiting and an increased rate of pharyngitis [7]. Numerous complications of infection caused by S. moniliformis have been described in the literature, including meningitis, pneumonia, endocarditis, and development of abscesses in various organs [7]. These complications are perhaps one of the reasons why a mortality rate of 10-13% is observed in the absence of proper antibiotic therapy [7] [8]. For this reason, early recognition is imperative to prevent complications.

Fever
  • Abstract Haverhill fever and rat-bite fever are closely-related syndromes caused by Streptobacillus moniliformis. This infection is characterized by the abrupt onset of fever with rigors, myalgias, headache, polyarthritis, and rash.[ncbi.nlm.nih.gov]
  • Haverhill fever is a term used to describe an infection by streptobacillus moniliformis, the causative agent of rat bite fever.[symptoma.com]
  • Haverhill fever (or epidemic arthritic erythema) is a form of "rat-bite fever" caused by the bacterium Streptobacillus moniliformis, an organism common in rats and mice. Symptoms begin to appear two to ten days after a rat bite injury.[en.wikipedia.org]
  • Haverhill fever的中文翻译及音标 沪江词库精选Haverhill fever是什么意思、英语单词推荐 例句 A fevered imagination 奔放的想象力. His medicines had failed; the fever was unabated 他的药剂未起作用。热度未减。 Be Bitten with;catch the fever for ..[hujiang.com]
  • It is often used in gout. ( latest outcomes from Allopurinol 105,745 users ) Haverhill Fever Haverhill fever (rat-bite fever"" caused by the bacterium streptobacillus moniliformis) ( latest reports from 2 Haverhill fever patients ).[ehealthme.com]
Chills
  • The illness resembles a severe influenza, with a moderate fever (38-40 C, or 101-104 F), chills, joint pain, and a diffuse red rash, located mostly on the hands and feet.[en.wikipedia.org]
  • He stayed home for two days and then returned to work in spite of weakness, chills, rises of temperature and night sweats.[jamanetwork.com]
  • Fever, headaches, fatigue, myalgia, migratory polyarthralgia (involving the hands, wrists, elbows and knees in most cases), vomiting, weight loss, diarrhea, and chills are clinical hallmarks of this infection.[symptoma.com]
  • […] rat bite, 1 or as epidemics of so-called Haverhill fever, presumably due to infected milk. 2 Regardless of source, the clinical picture resulting from infections with this organism is one of an acute infection with abrupt onset, and characterized by chills[annals.org]
  • […] called haverhill fever , or erythema arthriticum epidemicum , acute infection caused by the microorganism Streptobacillus moniliformis, transmitted to humans by rat bite or by the ingestion of contaminated foods and characterized by the sudden onset of chills[britannica.com]
Rigor
  • This infection is characterized by the abrupt onset of fever with rigors, myalgias, headache, polyarthritis, and rash. We report a case of infection with S. moniliformis that manifested as acute polyarthritis with involvement of the spine.[ncbi.nlm.nih.gov]
Malaise
Weight Loss
  • Fever, headaches, fatigue, myalgia, migratory polyarthralgia (involving the hands, wrists, elbows and knees in most cases), vomiting, weight loss, diarrhea, and chills are clinical hallmarks of this infection.[symptoma.com]
Hemoptysis
  • The pulmonary migration of larvae is associated with fever, cough, occasionally hemoptysis 蛔蚴肺部移行,可伴有发热、咳嗽、偶尔咯血。[hujiang.com]
Aspiration
  • Mycetoma Madura Foot 181 27 Fever and Lymphadenopathy 187 Clinical Syndromes 195 28 Acute and Chronic Bronchitis 197 29 Croup Supraglottitis and Laryngitis 205 30 Atypical Pneumonia 211 31 CommunityAcquired Pneumonia 221 32 Nosocomial Pneumonia 229 33 Aspiration[books.google.de]
Abdominal Pain
  • A 17-year-old boy with a previous history of gastrointestinal dysfunction had abdominal pain, fever, anorexia 一例17岁男孩,有胃肠功能不良史,主诉腹痛、发热、食欲减退。[hujiang.com]
Abdominal Cramps
  • Other symptoms include headache, fever, and abdominal cramps 其它症状包括头痛、发烧及腹痛 Therefore, although yellow fever has never been reported from Asia, this region is at risk because the appropriate mosquitos and primates are present.[hujiang.com]
Lacrimation
  • 8 Dental Infection and Its Consequences 59 9 Infection of the Salivary and Lacrimal Glands 65 10 Deep Neck Infections 73 PART III 77 11 Conjunctivitis 79 12 Keratitis 87 Keratitis Isolates 19932006 88 13 Iritis 97 14 Retinitis 103 15 Endophthalmitis 109[books.google.de]
Night Sweats
  • He stayed home for two days and then returned to work in spite of weakness, chills, rises of temperature and night sweats.[jamanetwork.com]
Migratory Polyarthritis
  • Firstly, recent consumption of "suspicious" food or beverages must be noted during history taking, whereas signs of vomiting and constitutional symptoms accompanied by a migratory polyarthritis could be sufficient to order further laboratory testing to[symptoma.com]
Meningism
  • Complications are rare, but can include endocarditis and meningitis. Despite its name, it can present without being bitten by a rat.The disease was recognized from an outbreak which occurred in Haverhill, Massachusetts in January, 1926.[en.wikipedia.org]
  • 505 74 Aseptic Meningitis Syndrome 513 75 Acute Viral Encephalitis 521 76 Intracranial Suppuration 531 Diagnosis and Management 541 78 Myelitis and Peripheral Neuropathy 547 79 Reyes Syndrome 563 80 Progressive Multifocal Leukoencephalopathy 569 81 Cerebrospinal[books.google.de]
  • Numerous complications of infection caused by S. moniliformis have been described in the literature, including meningitis, pneumonia, endocarditis, and development of abscesses in various organs.[symptoma.com]
Excitement
  • Douglas Jones Lippincott Williams & Wilkins , 2006 - 2808 من الصفحات Click here to view a narrated demo to see all the features of this exciting new Solution![books.google.com]
  • Not really as exciting as a lot of people had hoped, but the mayor seems psyched. Jim Fiorentini says: Thanks for the positive promotion of our city! Just stumbled upon this, thanks the the Mayor and his latest newsletter. Thanks Mayor.[haverhillfever.com]

Workup

Having in mind the very rare occurrence of Haverhill fever in medical practice, the diagnosis may be difficult to make, but a detailed patient history and a thorough physical examination can provide vital information for a presumptive diagnosis [1] [4]. Firstly, recent consumption of "suspicious" food or beverages must be noted during history taking, whereas signs of vomiting and constitutional symptoms accompanied by a migratory polyarthritis could be sufficient to order further laboratory testing to exclude S. moniliformis as the underlying cause of symptoms. A complete blood count (CBC), inflammatory parameters - C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and fibrinogen, as well as serum electrolytes and protein levels are recommended in workup, while microbiological studies, mainly cultivation of blood or joint fluid, is mandatory for the diagnosis of Haverhill fever [1] [7] [8]. Blood cultures can detect S. moniliformis after 3-7 days of growth, but because this bacterial pathogen requires specific media for cultivation, laboratories must be noted in advance, in order to prepare necessary components for testing [7]. The recent introduction of novel molecular techniques, such as polymerase chain reaction (PCR), has greatly improved the diagnosis of many microbial organisms, including bacteria, and this procedure should be performed whenever possible [1] [7] [8]. Due to its cost, however, it is still not widely available in the developing world, and the diagnosis still relies on high clinical suspicion and results obtained from cultivation [4].

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Treatment

  • The causative organism can be isolated by blood culture, and penicillin is the most common treatment. Treatment is usually quite successful, although the body can clear the infection by itself in most cases.[en.wikipedia.org]
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  • Streptomycin was used by us in the treatment of Haverhill fever for the first time, as far as we are able to determine. REPORT OF A CASE History.— B.[jamanetwork.com]
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]

Etiology

  • Due to the similar etiology, Haverhill fever and rat bite fever have the same clinical presentation, although different modes of infection are described.[symptoma.com]
  • Synonym: fifth disease Etiology The causative agent is human parvovirus B-19.[medical-dictionary.thefreedictionary.com]

Epidemiology

  • Epidemiology implicated infection via consumption of milk from one particular dairy.[en.wikipedia.org]
Sex distribution
Age distribution

Prevention

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  • For this reason, early recognition is imperative to prevent complications.[symptoma.com]
  • There are many diseases and conditions that can be damaging (or even fatal) to your child that can be prevented with vaccinations. And while many dis ...[chcmass.com]
  • Evaluation and Monitoring 681 Antiretroviral Therapy 689 98 Immune Reconstitution Inflammatory Syndrome 699 99 Differential Diagnosis and Management of Opportunistic 707 100 Prophylaxis of Opportunistic Infections in HIV Infection 721 PART XIII 731 101 Prevention[books.google.de]
  • Our physicians specialize in pediatrics including diagnostics, prevention, and treatment of conditions such as allergies , asthma , colds and flu , diabetes (type 1 and type 2) , ear infections , eczema and more.[chcmass.com]

References

Article

  1. Elliott SP. Rat Bite Fever and Streptobacillus moniliformis. Clin Microbiol Rev. 2007;20(1):13-22.
  2. Matheson K, Langley JM, Lang B, Mailman T. Polyarthritis, fever and a rash in a young girl. Can J Infect Dis Med Microbiol. 2008;19(1):73-74.
  3. Grude N, Tveten Y, Torp PØ, Laastad O. Rat-bite fever [Article in Norwegian]. Tidsskr Nor Laegeforen. 2001;121(26):3057-8.
  4. Booth CM, Katz KC, Brunton J. Fever and a rat bite. Can J Infect Dis. 2002;13(4):269-272.
  5. Akter R, Boland P, Daley P, Rahman P, Al Ghanim N. Rat Bite Fever Resembling Rheumatoid Arthritis. Can J Infect Dis Med Microbiol. 2016;2016:7270413.
  6. Andre J-M, Freydiere AM, Benito Y, et al. Rat bite fever caused by Streptobacillus moniliformis in a child: human infection and rat carriage diagnosed by PCR. J Clin Pathol. 2005;58(11):1215-1216.
  7. Mandell GL, Bennett JE, Dolin R. Mandel, Douglas and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pennsylvania: Churchill Livingstone; 2015.
  8. Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology. Seventh edition. Philadelphia: Elsevier/Saunders; 2013.

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Last updated: 2018-06-22 09:20