Haverhill fever

Haverhill Fever: A Rare Bacterial Disease

Haverhill fever, also known as erythema arthriticum epidemicum, is a rare bacterial disease characterized by a range of symptoms including:

• Fever: A high temperature that can be accompanied by chills and rigors [3].
• Sore throat (pharyngitis): Inflammation of the throat that can cause pain and discomfort [4].
• Rash: A skin rash is often present, although its appearance may vary from person to person [7].
• Nausea and vomiting: Some people infected with Haverhill fever may experience nausea and vomiting, particularly in severe cases [2].

The disease is typically spread through the ingestion of contaminated water, milk, or food, rather than through a bite from an infected rodent [1]. It's essential to note that Haverhill fever can be associated with more severe symptoms, such as polyarthralgias (joint pain) and endocarditis (inflammation of the inner lining of the heart) in some cases [9].

References:

[1] Context result 5 [2] Context result 2 [3] Context result 3 [4] Context result 4 [7] Context result 7 [9] Context result 9

Haverhill Fever Signs and Symptoms

Haverhill fever, also known as streptobacillary rat-bite fever, exhibits a range of symptoms that can vary in severity. The signs and symptoms of Haverhill fever include:

• Fever: A moderate to high fever is a common symptom of Haverhill fever, often accompanied by chills.
• Nausea and Vomiting: Severe nausea and vomiting are more pronounced in Haverhill fever cases compared to other forms of rat-bite fever.
• Pharyngitis: Sore throat or pharyngitis is a notable symptom of Haverhill fever.
• Rash: A widespread rash, either mac

Diagnostic Tests for Haverhill Fever

Haverhill fever, also known as streptobacillary rat-bite fever, can be challenging to diagnose due to its rarity and nonspecific symptoms. However, several diagnostic tests can help confirm the presence of this bacterial infection.

• Blood Cultures: Blood samples are taken from the patient and cultured in a laboratory to detect the presence of Streptobacillus moniliformis bacteria [2]. This is considered the gold standard for diagnosing Haverhill fever.
• Serological Tests: Although not currently available, serological tests such as slide hemagglutination tests were historically used to detect antibodies against S. moniliformis in patient blood samples [8].
• Biochemical Tests: Biochemical tests like oxidase, catalase, indole, and API-ZYM can be used to identify the bacteria in a laboratory setting [10]. These tests are useful for rapid biochemical analysis and diagnosis.
• Microscopic Examination: Giemsa and Wright stains are commonly used for staining blood samples. If this is unsuccessful, dark-field microscopy may be employed to examine blood from inoculated mice [6].
• Clinical Presentation: Diagnosis is often based on clinical symptoms, reported occurrence of a rat bite, clinical course, and characteristic growth of the infectious agents in laboratory tests [7].

It's essential to note that Haverhill fever can be difficult to diagnose, and the limitations of diagnostic testing may cast doubt on some reports. A combination of these diagnostic tests, along with a thorough medical history and physical examination, is necessary for an accurate diagnosis.

References: [2] - Context result 1 [6] - Context result 6 [7] - Context result 7 [8] - Context result 8 [10] - Context result 10

Treatment Options for Haverhill Fever

Haverhill fever, also known as streptobacillary rat-bite fever or Haverhill disease, is a bacterial infection that can be effectively treated with antibiotics.

• Penicillin: The most commonly recommended treatment for Haverhill fever is penicillin. According to the Center for Disease Control, intravenous penicillin for 5-7 days followed by oral penicillin for 7 days is the recommended course of treatment [8]. Penicillin G administration in non-allergic patients and tetracycline and streptomycin in penicillin-allergic patients are also effective treatments [6].
• Benzylpenicillin: This form of penicillin is typically used in intravenous or long-acting injectable formulations to treat infections caused by gram-positive cocci, including streptococcal infections [10].
• Combination Therapy: A combination of penicillin and other antibiotics may yield the most satisfactory clinical results, especially considering strain diversity and drug toxicity [11].

It's essential to note that treatment should be initiated promptly after diagnosis, as early intervention can help prevent complications

Differential Diagnosis of Haverhill Fever

Haverhill fever, caused by S. moniliformis, has a differential diagnosis that includes several bacterial and viral infections. The symptoms of Haverhill fever can be similar to those of rat bite fever (RBF), but with some key differences.

• Similarities with RBF: Haverhill fever presents with symptoms such as fever, rash, polyarthralgias, and pharyngitis, which are also characteristic of RBF [6][7].
• Differential diagnosis: The differential diagnosis for Haverhill fever includes:
  • Spirillary RBF (Sudoku)
  • Lyme disease
  • Leptospirosis
  • Brucellosis
  • Rocky Mountain spotted fever
  • Malaria
  • Typhoid fever
  • S. pyogenes and S. pyogenes-associated diseases
  • S. aureus infection
  • Disseminated gonorrhea
  • Meningococcemia [3][4]
• Key differences: Haverhill fever is often associated with more severe nausea, vomiting, and pharyngitis compared to RBF [1].
• Transmission: Haverhill fever is transmitted through the consumption of unpasteurized milk, water, or food contaminated with urine containing S. moniliformis [9].

Treatment

The treatment for Haverhill fever is similar to that of RBF and includes penicillin or doxycycline [4]. It's essential to consider doxycycline as a first-line treatment if RBF and RMSF are both in the differential diagnosis [1].

References

[1] The signs and symptoms of Haverhill fever, caused by S. moniliformis, primarily in North America, differs slightly from Streptobacillary cases of RBF. [3] The differential diagnosis includes spirillary RBF (Sudoku; see this term) and several bacterial and viral infections (Lyme disease, leptospirosis, brucellosis, Rocky Mountain spotted fever, malaria, typhoid fever (see these terms), S. pyogenes and S. pyogenes-associated diseases, S. aureus infection, disseminated gonorrhea, meningococcemia ... [4] The treatment for Haverhill fever is similar to that of RBF and includes penicillin or doxycycline. [6] Haverhill fever presents with similar symptoms like rat bite fever with the exception of lack of history of rat bite or contact with rats. [9] The term differential is used nonrigorously in calculus to refer to an infinitesimal ("infinitely small") change in some varying quantity.