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Direct detection of indirect transmission of Streptobacillus moniliformis rat bite fever infection.


ABSTRACT: We describe the evaluation of culture-negative synovial fluid from a 3-year-old boy by PCR and electrospray ionization followed by mass spectrometry (PCR/ESI-MS). Our patient developed a diffuse rash and fever with systemic signs and symptoms of sepsis, but four sets of blood cultures obtained prior to initiation of antibiotics were negative. After 1 week of illness, he developed right-knee swelling. Analysis of synovial fluid was consistent with infection, but cultures of specimens obtained following initiation of antimicrobial treatment were negative for growth. PCR/ESI-MS detected Streptobacillus moniliformis in the synovial fluid sample. Our patient completed an appropriate course of antibiotic treatment and remained completely asymptomatic in follow-up evaluation. This unique case suggests that PCR/ESI-MS may be a useful diagnostic tool for direct detection of unusual or unexpected pathogens directly from clinical specimens, particularly when samples have been obtained from patients following initiation of antibiotic therapy.

SUBMITTER: Mackey JR 

PROVIDER: S-EPMC4042756 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Direct detection of indirect transmission of Streptobacillus moniliformis rat bite fever infection.

Mackey Joseph R JR   Melendez Elsa L Vazquez EL   Farrell John J JJ   Lowery Kristin S KS   Rounds Megan A MA   Sampath Rangarajan R   Bonomo Robert A RA  

Journal of clinical microbiology 20140409 6


We describe the evaluation of culture-negative synovial fluid from a 3-year-old boy by PCR and electrospray ionization followed by mass spectrometry (PCR/ESI-MS). Our patient developed a diffuse rash and fever with systemic signs and symptoms of sepsis, but four sets of blood cultures obtained prior to initiation of antibiotics were negative. After 1 week of illness, he developed right-knee swelling. Analysis of synovial fluid was consistent with infection, but cultures of specimens obtained fol  ...[more]

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