Severe Pediatric Leptospirosis Caused by a Pet Rat

Background: Leptospirosis is a bacterial infection which may cause multiple aspecific symptoms, such as a fever, myalgia, a headache and abdominal pain. Transmission of the disease can occur via rats or surface water infected by rats. The Netherlands saw a record number of cases of leptospirosis in 2019. Diagnosis is often delayed and not always considered because of the variable clinical presentation of the disease.

No rules or quality certificates regarding disease prevention currently exist for breeders of pet rats.

Case report: An 11-year old girl visited the pediatrician with fever, myalgia and a headache followed by a stiff neck. Two days earlier she was bitten by one of her pet rats. Diagnostic testing confirmed a meningitis caused by leptospirosis-infection. She received a seven-day intravenous treatment with ceftriaxone. The pet rats were found to be infected with leptospirosis. The rat breeder also developed symptoms and was treated with antibiotics. All of his rats were euthanized.

Conclusion: Consider the diagnosis leptospirosis in patients with unexplained aspecific symptoms combined with rat exposure. More awareness of zoonoses is needed among physicians and pet breeders.