A case of meningitis caused by Rat-bite fever : Streptobacillus notomytis specific gene detected from cerebrospinal fluid

Abstract

We experienced a case of meningitis caused by Rat-bite fever, Streptobacillus notomytis. Because of the S. notomytis specific gene detected from cerebrospinal fluid and the polymorphism-negative bacilli found in equine blood medium carbon dioxide culture, we could diagnose the meningitis caused by S. notomytis. We administered ampicillin which was reported to be effective against rat-bite fever in addition to meropenem for the 1st hospital day. As a result, the patient recovered from Rat-bite fever. Compared with the Rat-bite fever caused by S moniliformis, this case is characterized by the absence of preceding septicemia, no rash, and a long incubation period. It was difficult to diagnose without taking detailed medical history.