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ABSTRACT Introduction Endocarditis is a rare, often fatal complication of rat bite fever caused by Streptobacillus moniliformis. Only 39 cases have been reported (including this case) as of 2022. We describe a case and aim to perform this entit's first systematic literature review. Methods We performed a systematic review in CENTRAL, EMBASE, MEDLINE, SciELO, and LILACS. The terms used were terms used were (but not limited to) rat bite fever, Streptobacillus moniliformis, Spirillum minus, and endocarditis. We included all abstracts and articles with patients with echocardiographic or histologic-proven endocarditis. In case of discordance, a third reviewer was involved. Our protocol was submitted to PROSPERO (CRD42022334092). We also performed searches for studies on the reference list of included articles. Results We retrieved 108 and included 36 abstracts and articles. A total of 39 patients (including our report) were identified. The mean age was 41.27, and 61.5% were males. The most common findings were fever, murmur, arthralgias, fatigue, splenomegaly, and rash. Underlying heart disease was present in 33%. Exposure to rats was noted in 71.8% of patients, with 56.4% recalling a rat bite. Anemia was seen in 57%, leukocytosis in 52%, and elevated inflammatory markers in 58% that had lab work performed. The mitral valve was most affected, followed by the aortic, tricuspid, and pulmonary valves. Surgical intervention was required in 14 (36%) cases. Of those, 10 required valve replacement. Death was reported in 36% of cases. Unfortunately, the literature available is limited to case series and reports. Conclusion Our review allows clinicians to suspect better, diagnose, and manage Streptobacillary endocarditis.
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Background: The world’s adolescent population (age 10–19 years) is estimated to stand at more than 1 Billion, yet adolescents remain largely neglected, difficult-to-measure, and hard-to-reach. Population in which the needs of adolescent girls, in particular, are often ignored. Anemia during adolescence limits growth and delays the onset of menarche, which in turn may later lead to cephalopelvic disproportion. In armed forces young serving soldiers make the backbone of forces, anemia in this group affects man hour badly. So, study was planned to assess prevalence of anemia in these two groups.Methods: A prospective study was carried out with 340 girls and 500 serving adults and prevalence of anemia was carried out with respect to different prevailing factors.Results: The prevalence of severe, moderate and mild anemia in girls was 0.5%, 10.6% and 27.9% respectively and in serving soldiers prevalence of anemia was 1.8%, 2.8% and 3.4 % respectively.Conclusions: In the present study, the prevalence of anemia was found to be 39% in adolescent girls and 8% in serving soldiers. Strongest predictor to anemia in adolescent girls was history of excessive menstrual bleeding and vegetarian diet. Age group, age at menarche and BMI did not affect anemia prevalence. Strongest predictor to anemia in soldiers was age.