A spirillum was repeatedly recovered by blood culture from two children. This organism resembled the Spirillum minus which has long been associated with one form of rat bite fever, Sodoku. In Sodoku the spirillum is usually recovered by animal inoculation and no previous record has been found in which a diagnosis has been made by blood culture.The organisms recovered from the two patients were morphologically indistinguishable from the classical Spirillum minus, but were unique in that they could be maintained for many months on standard liquid and solid bacteriologic media. Their in vivo resistance to penicillin and arsenicals was marked and therefore also unusual.Both patients were seen because of recurrent fever, eruption and symptoms referable to the central nervous system, respiratory and intestinal tracts. The first child was admitted to The Mount Sinai Hospital debilitated and febrile. A spirillum was recovered repeatedly on routine blood culture, although there was no definite history of rat bite. Treatment with arsenicals and penicillin and streptomycin failed and the patient died. The second child was admitted with a history of repeated respiratory infections and indolent skin ulcers and hemiplegia. He had apparently been bitten by a rat while in Florida 3? years before the spirillum was first recovered from his blood. Treatment with penicillin and sulfarsphenamine was ineffectual. The organism was sensitive in vitro to streptomycin but as much as 2 gm. a day for several months failed to do more than induce several negative blood cultures. Treatment with aureomycin finally succeeded in sterilizing the blood stream and healing the ulcers. Coincident with this there was a striking improvement in the child's general condition.The clinical course of these two patients and the unusual bacteriologic findings set them apart from classical rat bite fever and suggest use of the term "Spirillum Fever."
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