Fever and Red Spots CaseReturn to Rat Bite Fever Lecture

Fever and Red Spots Case

On Thursday, August 13, 1998, our two children arrived at a Pet Store at approximately 10:30 a.m. to volunteer for one hour, helping to change water bottles and food for the animals.

In a rat cage were three adult rats and three or four babies, a hairless breed.  I asked where they came from and was told someone had dropped them off.  At approximately 11:00 a.m. our youngest daughter, ________, was bitten on the right index finger by one of the adult hairless rats.  The bite was quite severe and bled for a few minutes.  She washed it immediately and I applied a disinfectant.  __________, the store manager, applied a Band-Aid.

On Monday, August 17, _______ had a slight fever.  On Tuesday, August 18, she had a fever, her right wrist was sore and she had red spots on her arms.  I called Kaiser and made an appointment.  On Wednesday, August 19, she was seen by Dr. Loftus.  She had a fever, her right wrist was sore and swollen, and she had red spots on her arms and blotchy spots on her legs.  I informed the doctor that ________ had been bitten by a pet store rat.  Dr. Loftus says it is rare to contract an infection, but orders a blood culture in addition to strep culture, and wrist xray.  The strep culture was normal, the wrist xray normal, the white cell count normal in the blood.  The blood culture would not be available for a few days.

After leaving Kaiser, we go to the Pet Store to buy crickets.  One of the adult hairless rats is gone.

The next morning we had airline tickets, and condo arrangements, for Maui, Hawaii.  Thinking this was probably a simple virus, Dr. Loftus thought it was okay to continue our vacation plans.  We left Wednesday night, spending the night in San Francisco.  Our flight was to leave Thursday, August 20, 1998, at 8:00 a.m.

Thursday morning, around 5:30 a.m. as we were getting ready to be shuttled to the airport, _______ had a fever of 104oF.  We gave her Tylenol to reduce.  We boarded the plane at 7:30 a.m.  At this time her fever was at 101.2oF  She slept most of the flight and high fever returned.

We landed on Maui, picked up our rental car and drove directly to Kaiser.  There ________ was examined by Dr. Raj, had another blood test and strep test.  We spent about 2 hours there and then checked in to our condo.  We were to see Dr. Raj the next day, Friday.

Friday, August 21, _________ has a fever of 104.3oF.  The soreness has traveled to her left wrist, and left knee.  She says her neck is sore.  The red spots are now on her hands, legs and feet.  We then return to Kaiser to see Dr. Raj.  Dr. Raj orders another blood test, and an opthamology exam.  She had been in contact with Dr. Loftus.  ________s blood test in California indicates a bacteria is growing, but it cannot be identified at the time.  Dr. Raj is reluctant to administer antibiotics without positive ID and prescribes Motrin.

On Saturday, August 22, ________ continues to have a high fever, severe joint pain and red spots on her body.  We give her Tylenol and Motrin.  We consult with Dr. Johnson, the weekend doctor at Kaiser, Santa Clara.  No results yet on the blood culture.

On Sunday, August 23, _________s fever is 104.8oF.  She continues to have severe joint pain, swelling of both wrists, knees, and red spots on her body.  We leave a message for Dr. Johnson to call us.

On Sunday, August 23, we receive a call at 8:00 a.m. from Dr. George Talbot, of Kaiser, Kihei, Maui.  He says he will meet us at Kaiser Emergency in about 1 hour.  We meet, he examines Kristen, and determines from the conversation with Dr. Johnson, the blood culture results, and his data book of symptoms that this is most probably caused from the rat bite. He orders another blood culture and a deep muscle injection of penicillin.

On Monday, August 24, _________s fever slowly decreases 102.3oF, 101.2oF, 100.1oF.  Her feet start to blister in the places the red spots had appeared.  Her joints are still swollen and arthritic.

On Tuesday, August 25, ________s fever is down to 99.1oF.  She continues to have a reading of 99oF throughout the day through Friday.   I spoke to Dr. Loftus on Wednesday, August 26, and she wants to see ______ the day after we are scheduled to return home.  We arrive home Thursday evening, August 27.

On Friday morning, August 28, I phone Kaiser and schedule an appointment to see Dr. Loftus at 5:00 p.m.

Around 10:00 a.m. on Friday, August 28, I phone the Pet Store in Mtn. View.  I speak with the owner.  I inform him what has happened to our daughter.  He then tells me this happened about 3-1/2 years ago, at his store, to a little girl and she had to be hospitalized at Stanford for about 1-1/2 weeks, on an i.v.  He asks if ________ has swollen joints, fever and a rash.  I mention the fact that, since he has children volunteering in his store during the summer, parents should be informed of the potential bacteria contracted by rat bites.

On Friday, August 28, around 2:30 p.m., after speaking with ______, my children and I go to the Pet Store.  The two adult hairless rats and three or four babies are still in the cage, displayed to the public.

When we arrive at Kaiser at 5:00 p.m., Dr. Loftus examines _______.  She continues to have a swollen left wrist,  red spots on her feet and now a slight heart murmur.  Dr. Loftus immediately admits her to Kaiser, Redwood City.   She will spend several days on i.v. penicillin.  She was discharged September 2.

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