Rat bite fever due to Streptobacillus moniliformis induces typical but not 
pathognomonic clinical signs, such as local purulent wound infection followed by 
maculopapular exanthema, myalgia as well as purulent joint infections. Severe 
complications, such as osteomyelitis and endocarditis are possible. it seems 
that this infection is rarely diagnosed but this infection could be much more 
common because the final diagnostic proof is difficult to achieve. Firstly, the 
culture of these bacteria is critical because the bacteria are fastidious and 
secondly the exact differentiation of the isolates is hardly possible by 
standard laboratory methods. Modern techniques such as mass spectroscopy 
(MALDI-TOF) and molecular biology allow a precise clarification. Surgical 
cleansing of infection sites in combination with a rational antibiotic therapy, 
for example with beta-lactam antibiotics, are generally able to cure the 
infection if treatment is started early enough. In addition, vaccinations, for 
example against tetanus and rabies have to be considered in this situation as 
for all other bite wound infections.