OK this is weird!
Are we back in the dark ages where the plague was rampant or are the following cases a reflection of our choice of pets or poor living conditions?
The CRA in beautiful Lake Louise is a serene remote setting where it is hard to imagine rats carrying the dreaded plague. However, two posters presented cases of rat bite fever where the differential included septic arhtritis or even rheumatoid arthritis. Congratualtions to Ripa Akter from Memorial University and Maeve Gamble from Western University for submitting cases that should be from a bygone era.
I have broadened my differential diagnosis in the appropriate setting to include Yersinia pestis - a gram-negative rod that is the cause of Bubonic plague.
We can now add to all our other fears of potentially deadly infections, so Ebola should not be your only fear as rat bite fever is in Canada!
Dr. Janet Pope is Professor of Medicine at Western University and Division Head of Rheumatology. Dr. Pope's research interests include epidemiologic studies in scleroderma, classification criteria in systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis.View Full Bio