Severe leptospirosis after rat bite: A case report

About the Authors: Thais Faggion Vinholo Affiliation: Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States ORCID logo http://orcid.org/0000-0002-9572-6861 Guilherme S. Ribeiro Affiliations Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil Nanci F. Silva Affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil Jaqueline Cruz Affiliation: Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil Mitermayer G. Reis Affiliations Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil Albert I. Ko Affiliations Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil Federico Costa * E-mail: Federico.costa@ufba.br Affiliations Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil, Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom ORCID logo http://orcid.org/0000-0001-6951-2336 Citation: Faggion Vinholo T, Ribeiro GS, Silva NF, Cruz J, Reis MG, Ko AI, et al. Funding: The study was supported by grants from the Fogarty International Center (R25 TW009338, R01 TW009504) and National Institute of Allergy and Infectious Diseases (F31 AI114245, R01 AI121207) from the National Institutes of Health; the UK Medical Research Council (MR/P0240841), the Wellcome Trust (102330/Z/13/Z), and the Fulbright Foundation. Clinical examination recorded a temperature of 38.0°C, blood pressure of 117/72 mmHg, heart rate of 100 beats per minute, respiratory rate of 16 breaths per minute, and oxygen saturation of 99% breathing room air, in addition to dehydration. [...]we cannot exclude the hypothesis that the entry for leptospires could have happened through direct contact from residual urine tracked by the rat once the skin was broken.