There has been at least one case of rat bite fever in a domesticated rat in the US:
Interesting case. There is always a new twist on the newborn with a possible infection, but this is a doozy!
> On Nov 10, 2017, at 10:18 PM, Alicia Tezel <[log in to unmask]> wrote:
> This from a peds ID friend
> Hi Alicia,
> Interesting case!
> I'm not really sure I would trust that rat-bite fever can be ruled out in a
> rat from a "reputable breeder". I would need to look into this further.
> I'm also nervous when people describe skin findings in a newborn without
> actually seeing them. It sounds like it was very soon after the bite though
> that the child was seen, so unlikely to be cellulitis. A baby this age with
> cellulitis- I would recommend admitting for IV antibiotics and close
> To answer some of the questions that were posed,
> 1. A protective maternal antibody titer against tetanus can be presumed to
> be protective for baby. However, it often takes a while for this test to
> result, so I would rather rely on maternal vaccination history.
> 2. I don't think that you can totally rule out rat bite fever. There are
> cases of initial recovery from very minor clinical illness, only to be
> followed by relapsing fever for weeks or months. Furthermore, the
> incubation period can be up to 3 weeks.
> 3. I definitely would have given 3 doses of amox-clav or maybe even IM
> penicillin (considering unreliable gut absorption in this age group), for
> peace of mind if nothing else.
> 🌷 Alicia 🌷
> Sent from my iPhone
> On Nov 10, 2017, at 11:29, George Kristinsson <[log in to unmask]>
> Question to the group, especially the infectious disease inclined
> colleagues of ours:
> The other day we've seen here in our regional pediatric ED a 2 (two) day
> old baby after a house rat bite. Yes, that‘s a new one for us! Basically
> the fresh baked mother and her baby went upon discharge straight from the
> maternity ward to a friends home visiting, where at some point someone
> noticed the house rat at the newborns hand. (The baby was in a car seat on
> the floor next to them)
> By the time the baby presented to our ED – thats right after the incident –
> the middlefinger oft he left hand was slightly swollen and red, with what
> it seems a superficial abrasion on the lateral nailfold with a little dried
> blood on it.
> We were hard pressed how to proceed about this case and unfortunately the
> ID people oft he regional tertiary care center we contacted, after washing
> the wound, wouldnt want to consult without seeing the Baby and asked the
> otherwise healthy newborn to be sent to their ED.
> Meanwhile the local veterinary authorities rule out that domestic rats from
> „reputable breeder“ (?) could transmit rat bite fever.
> Instead to sent the kid crosscountry to a busy ED we opted to follow the
> newborn and the conditions at home ourselves daily through the visiting
> midwife at home and clinical checks at our outpatient clinic. It is day 5
> of live, respectively day 4 since the incident and the finger shows only
> some minuscule nick oft he cutis in the nailfold. Otherwiese the baby is
> doing fine. At this point we do have few questions, and wonder how others
> would have gone about this unusual case:
> -What about tetanus: is a presumably titer of maternal antibodies enough of
> a protection?
> -Can rat bite fever truely be ruled out?
> -Would anybody had given a preventive 3 day course of Co-Amoxi as many
> propably would have done in an older toddler / child?
> -How long to follow the newborn?
> -Any other thoughts?
> Thank you
> George Kristinsson
> Spital Buelach, Switzerland
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