🐀 Chapter 766 · Rat Bite Fever

Nelson Textbook of Pediatrics 22nd Edition | Rat bite fever (RBF): Streptobacillus moniliformis (US, Europe) – Haverhill fever, rash (morbilliform/petechial), arthritis, relapsing fever. Spirillum minus (Asia – sodoku, indurated ulcer, lymphadenopathy). Treatment: Penicillin G (IV then oral). Doxycycline or gentamicin for penicillin allergy. 10-15% mortality if untreated.

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📋 30 Clinical Scenarios — Rat Bite Fever

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Rat Bite Fever

Select a clinical presentation to review diagnosis and management (Nelson Ch 766).

📋 Stepwise Management of Rat Bite Fever

🔑 Key Principles — Chapter 766
• Streptobacillus moniliformis (US/Europe): Incubation 3-10 days. Fever, rash (morbilliform/petechial, hemorrhagic vesicles), migratory polyarthritis. Haverhill fever (ingestion).
• Spirillum minus (Asia – sodoku): Incubation 14-21 days. Indurated ulcer at bite site, lymphadenitis, relapsing fever.
• Treatment: Penicillin G 50,000 U/kg/day IV for 7-10 days, then oral penicillin V for 7 days. Doxycycline or gentamicin for penicillin allergy.
• Mortality untreated: 10-15%.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Rat Bite Fever (Nelson 766)