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Rat bite incidents involving humans in the UK are reportedly very rare. There is only one report in the medical literature of severe eyelid injuries to an infant, caused by a rat.1Elsewhere in the world they are more widely recognised. A recent review from the USA reported that most occur in poverty stricken urban areas, in warmer months of the year, to children under 5 years. They most frequently occur at night, while asleep in the home and predominantly involve uncovered extremities.2
This 6 week old infant presented at 5 15 am on a September morning, with the injuries shown (fig 1). His parents reported that he was sleeping in a car seat on the floor beside their bed. His mother was awoken by crying. She noted he was “covered in blood”, while the father reported “something running across the floor”.
They lived in a privately owned, ground floor flat, with cellar, originally built in 1886. A down-pipe entering the main drainage system had been only partly covered with boarding. There were ongoing local sewage repairs.
Full examination revealed a finger tip laceration, but no other injuries in an otherwise well baby. The seriousness of the injuries and the lack of an apparently consistent history to explain their occurrence led to initial concern regarding non-accidental injury. The infant was seen by maxillofacial surgeons who raised the possibility of animal bites/scratches. Details, including photographs and measurements, were forwarded to a forensic odontologist. He concluded that the injuries were “highly likely to be rodent bites, probably caused by a large rat”.
Three days later a trap, laid in the home, caught a large, male rat measuring 29 cm nose to tail (fig 2), average size of rats being 20–25 cm.
Many of the case characteristics are consistent with those reported around the world. It is possible that such injuries occur more frequently in the UK and are unrecognised or unreported.
We acknowledge Dr D Whittaker, Reader in Oral Biology, University Hospital of Wales Dental Hospital, Heath Park, Cardiff and Mr P Judge, Technical Officer, Environmental Health Department, Cheltenham Borough Council.