From the Research
For a patient with neurological symptoms after rat exposure, I would recommend checking for leptospirosis with a microscopic agglutination test (MAT) and PCR of blood or urine, as well as testing for rat-bite fever with blood cultures and serological tests, as these infections can cause severe neurological complications but are treatable with antibiotics if caught early. The patient's symptoms could be indicative of leptospirosis, a zoonotic disease caused by Leptospira spp, which can cause meningitis and other neurological complications, as seen in a study published in 2010 1. Additional important tests include:
- Complete blood count, which can help identify declining haemoglobin, marked thrombocytopenia, and a normal to high total leukocyte count, indicative of severe disease, as shown in a study published in 2017 2
- Comprehensive metabolic panel
- Cerebrospinal fluid analysis if meningitis is suspected
- Tests for hantavirus (IgM antibodies and PCR)
- Tests for lymphocytic choriomeningitis virus (LCMV) with IgM and IgG antibodies Rat-bite fever, caused by Streptobacillus moniliformis or Spirillum minus, can also lead to neurological manifestations and requires prompt antibiotic treatment, as highlighted in a study published in 2001 3 and another in 1985 4. A study published in 2001 5 also emphasizes the importance of considering rat-bite fever as a possible diagnosis when fever, rash, and exposure to rats are part of the patient's history. Early diagnosis is crucial as these infections can progress rapidly but are generally treatable with appropriate antimicrobial therapy if caught early.