Streptobacillus moniliformis endocarditis in an HIV-positive patient

Streptobacillus moniliformis is the causative agent of rat bite fever, with endocarditis being a rare but well-documented complication. We report the case of an HIV-positive man who acquired S. moniliformis endocarditis throu gh a rat bite. No predisposing cardiac lesion was known. He was treated wit h ceftriaxone 2 g/day iv for 3 weeks, gentamicin 120 mg/day iv for 2 weeks and penicillin 24 x 10(6) units/day for 1 week. At the end of the antibioti c thera py he suffered a generalized Candida albicans infection, which was treated with fluconazole for 1 week. He was subsequently discharged in a sa tisfactory condition.