 and as of the day after discharge, the results of the microbiology still are not back yet.  The patient, however, appeared to be responding well to levofloxacin.  I gave her a 2-week course of 750 mg a day of levofloxacin, and I have instructed her to follow up with Dr. XYZ in the meantime.  Hopefully by then we will have a final identification and susceptibility on the organism and the tularemia and leptospirosis serologies will return.  A thought of ours was to add doxycycline, but again the patient clinically appeared to be responding to the levofloxacin.  In addition, I told the patient that it would be my recommendation to get rid of the rats.  I told her that if indeed the rats were carriers of infection and she received a zoonotic infection from exposure to the rats, that she could be in ongoing continuing danger and her children could also potentially be exposed to a potentially lethal infection.  I told her very clearly that she should, indeed, get rid of the animals.  The patient seemed reluctant to do so at first, but I believe with some coercion from her family, that she finally came to the realization that this was a recommendation worth following.