Israel Medical Association Journal

Rat-bite fever (RBF) is a rare zoonotic infection caused by Streptobacillus moniliformis or Spirillum minus. It is typically transmitted through contact with rats. In the United States, Streptobacillus moniliformis is the predominant causative agent, whereas in Asia, cases are more commonly attributed to Spirillum minus. We report a case of RBF in Israel, in which the identified pathogen was Streptobacillus moniliformis, a pleomorphic, Gram-negative bacillus. The classic clinical presentation of RBF includes fever, rash, and arthralgia, which may be migratory in nature.

Coronavirus disease 2019 (COVID-19) affects different people in different ways. Most infected people develop mild to moderate illness and recover without hospitalization. This case report presents a patient who had difficulty eradicating the corona virus due to being treated with rituximab, which depletes B lymphocytes and therefore disables the production of neutralizing antibodies. The regen-COV-2 antibody cocktail consists of two monoclonal antibodies, casirivimab and imdevimab. This cocktail successfully helped the patient's immune system eradicate the virus without auto specific severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody production. In vitro studies confirm that eradication of the intact the virus. This case report emphases the importance of providing external antiviral antibodies regularly, like the regen-COV-2 antibody cocktail, as post- and even pre- SARS-CoV-2 infection prophylaxis in patients treated with rituximab.