[Rat bite fever in children]. / Rattenbeetziekte bij kinderen.

BACKGROUND: Worldwide, disease in children due to exposure to rats is increasing, also in the Netherlands. Not only the generally known pathogen Leptospira should be considered, also S. moniliformis, Yersinia pestis, Lymphocytic choriomeningitis virus, Hantavirus, Francisella tularensis and Pasteurella multocida are also known rat-associated zoonosis. CASE DESCRIPTION: An 12-year-old boy visited the pediatrician with fever, headache and nausea, followed by generalized erythema and arthritis. The boy had a pet rat. The patient's blood culture was positive for S. moniliformis. The patient was treated with antibiotics and made a full recovery. CONCLUSION: Just like many rat-associated diseases have 'rat-bite fever' caused by S. moniliformis an nonspecific clinical presentation. It is not necessary to have had a rat bite, to develop rat-bite fever. Better awareness and knowledge about rat related diseases should contribute to earlier diagnosis and treatment. Which is of great importance because of increased morbidity and mortality associated to rat related diseases.

[An outbreak of respiratory tract infections in an institution: combating Mycoplasma pneumoniae in mentally disabled persons]. / Een uitbraak van Mycoplasma pneumoniae in een instelling voor mensen met een verstandelijke beperking.

BACKGROUND: In October 2013, the Municipal Health Service, Rotterdam, the Netherlands, was notified of an outbreak of Mycoplasma pneumoniae infections in an institution for mentally disabled persons. CASE DESCRIPTION: A total of 58 potential infections were identified, of which 12 were confirmed in the laboratory, 5 with PCR testing on throat swabs, 3 by an increased IgM value in the serum, 2 via IgM seroconversion and 2 with an increased IgG titer in consecutive serum samples. To combat the outbreak, measures were taken in collaboration with the municipal health service. Every patient who coughed with fever or malaise was considered to be potentially infected and immediately treated with antibiotics, with as much cohort nursing as possible. The staff made every effort to explain the more stringent hand and cough hygiene measures to the residents. CONCLUSION: An outbreak of Mycoplasma pneumonia in an institution for mentally disabled persons was controlled through active disease surveillance, treatment of potential cases and hygiene measures.