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Affiliation
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Surgery, Health Sciences, School of Medicine, University of Pretoria, Pretoria. |
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Abstract
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BACKGROUND: Rat bite injuries were observed as early as AD 1300. Up to date no literature exists that looks at the different clinical manifestations of rat bite injuries, and furthers a proposed management plan that is evidence based.
METHOD: We studied 59 patients who sustained rat bite injuries from July 2010 to 2014. Injuries were classified based on the pattern and natural history. Epidemiological and clinical data were correlated with the grading system and management employed.
RESULTS: The pattern of injury was described and classified into mild, moderate and severe. Children aged 1 year and younger sustained mild forms of injury while those older than 1 year had more moderate to severe injuries (p = 0.0006); that was the very same group that manifested a higher inflammatory response as evidenced by a temperature of > 38o C (p = 0.0238). There was no association between age and anatomical site of injury (p = 0.8313). The highest incidences were seen in Ivory Park (30.5%), which is the largest and most impoverished section in Tembisa.
CONCLUSION: In this study, the data showed three distinctive patterns of injury: graded mild, moderate and severe. The mild injuries heal without consequences and may be managed as outpatients. Penicillin monotherapy is sufficient to prevent or treat secondary infection. The few patients who received antirabies treatment did not show clinical benefit, thus we do not recommend its routine use. However, in areas where there is rabies outbreak it may be prudent to prescribe it. Mortality due to rat bite injuries is rare, but disfigurement may be devastating.
Language: en |