Infective endocarditis after multiple rat bites in a patient with diabetic neuropathy: If not Streptobacillus moniliformis, what else should be suspected?

Abstract

Painless rat bites in patients with diabetic neuropathy are very rare occurrence and may result in foot ulcers, amputations, or rat bite fever. Infective endocarditis complicating rat bites are extremely rare and almost exclusively a complication of rat bite fever caused by Streptobacillus moniliformis (a common microbial flora of the rat mouth). To the best of our knowledge, this is the first report of Staphylococcus aureus (another common flora of rat teeth) native valve endocarditis complicating rat bite.