Rat Bites in the Diabetic Foot

NewsBot · Oct 15, 2019

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Rat Bites in the Diabetic Foot: Clinical Clues.
Teelucksingh S et al
Am J Med. 2019 Oct 10

BACKGROUND:
Ulcers in diabetic neuropathic feet are quite common but should be differentiated from the distinctive but rare ulceration due to rat bite in these insensate feet. We describe and analyse the features of rat bites in 2 patients with diabetic neuropathic feet and highlight 8 clinical features that should raise suspicion and alert the clinician to this possibility.

METHODS:
We describe and analyse the features of rat bites in 2 patients with diabetic neuropathic feet and highlight the distinctive clinical features of this condition.

RESULTS:
The following features were noted: (1) blood on bed sheets on waking, (2) painless, non-suppurating ulceration, (3) multiple ulcers that are linear, sharp or with serrated edges, (4) varying depths within the ulcer, (5) sudden onset (was not noted the day before but found in morning),(6) ulcers not contiguous,(7) often bilateral and (8) the sole of the foot is not involved. Early recognition and prompt treatment resulted in digit and limb salvage.

CONCLUSIONS:
We describe and analyse the features of rat bites in 2 patients with diabetic neuropathic feet and highlight 8 clinical features that should raise suspicion and alert the clinician to this possibility.
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NewsBot · Oct 5, 2021

Diabetic foot ulcer following a rat bite: A case
report
Okonkwo C. C, Ihediohanma O. N, Nebuwa C. N, Mbaike A, Anyanwu A.C
African Journal of Diabetes Medicine Vol 29 No 5 August 2021

Diabetic foot ulcers are associated with significant morbidity and mortality in individuals living with diabetes mellitus. It is also a leading cause of non-traumatic amputation
worldwide. The most important predisposing factor for diabetic foot ulcer is peripheral neuropathy. Precedent events
leading to diabetic foot ulcers include trauma, wearing of
tight, fitting shoes and burns. Rat bites are an uncommon
but important cause of ulcer in patients living with diabetes, especially in low socio-economic strata like Nigeria. The
patient living with diabetes described here was from a rural
setting and presented to us with foot ulcers secondary to rat
bites. Rat bites are a very preventable cause/predisposing
factor for foot ulcers and patients need to be more enlightened on measures to reduce the occurrence of foot ulcers as
a result of rat bites and in addition, a good knowledge of
daily foot examination by the patient.
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