Rat bite injuries in children: description of a novel classification

Abstract

Rats are common intruders into human settlements. Apart from their role as disease vectors, they can also cause bite injuries. We describe the clinical course of a series of children with rat bites, and characterise the injures. A retrospective review of hospital records of children admitted for rat bites in a large regional hospital was undertaken. The demographics, wound characteristics, treatment given and clinical outcome of the patients are described. Fifty-nine children, with a mean age of 3.7 years, were admitted for rat bites. Three distinct types of wounds were treated: superficial scratches (Type I), deeper bites often with infection and ulceration (Type II) and full-thickness with loss of skin or underlying soft tissues (Type III). Few wounds displayed signs of inflammation. Only some Type II injuries required urgent local surgery in the form of drainage and debridement. Type III wounds required a skin graft. All patients recovered. We suggest that treatment of rat bites should be based on the wound type. Most patients do not require hospital admission or antibiotic treatment. Treatment should be mostly conservative wound care management. Surgery is only indicated for drainage of pus, debridement, skin graft or rarely reconstruction.