Bite Wound Lecture

Text-only Preview

Management of Human and Animal Bite WoundsAn OverviewBite Wounds• Serious infections can result from wounds that are caused by bites from animals and humans • Organisms recovered from bite wounds generally originate from the oral cavity of the biting animal, as well as from the patient's skin floraBite Wounds• Anaerobes have been isolated from animal and human bite wound infections, especially those associated with abscess formation• Common complications: – lymphangitis, septic arthritis, tenosynovitis, and osteomyelitis• Uncommon complications: – endocarditis, meningitis, brain abscess, and sepsisBite Wound Overview• >1 million animal bites occur in the United States each year• Dog bites account for 80% to 90% of all bite wounds • Incidence of dog bites is higher in young children than in adults• The bites in children frequently involving the head, face, or neck• 4% of patients seen in the ED for a dog-bite wound require hospitalization• 2% to 20% of dog-bite wounds become infected• Each year, more than a dozen deaths are caused by dog bites Bite Wound Overview• Cat bites account for 5% to 15% of bite wounds• >½ occur in adults, and cat bites are more common in women• Cat bites are almost always puncture wounds, and the rate of infection is estimated to be 30% to 80%Bite Wound Overview• Human bites account for 2% to 3% of all reported bites with ¾ caused by aggressive acts• Are either occlusional, usually seen in a sexual crime or child abuse, or clenched fist, usually the result of punching a person in the mouth• An estimated 10% to 50% of human-bite wounds become infectedMicrobiology (General)• Streptococcus pyogenes has been found in human bites• Pasteurella multocida in animal bites (60% of bacteremia cases) with Pasteurella septica causing central nervous system symptoms• Eikenella corrodens in both animal and human bites (although predominantly in human bites)Microbiology• Dog bites: Capnocytophaga canimorsus (formerly CDC group DF-2), Capnocytophaga cynodegmi, Neisseria weaveri (formerly M-5), Weeksella zoohelcum (formerly IIj), Neisseria canis, Staphylococcus intermedius, NO-1, and EO-2. • Pig bite: Flavobacterium IIb-like organisms • Horse and sheep: Actinobacillus speciesMicrobiology• Marine setting: Vibrio species, Plesiomonas shigelloides, Aeromonas hydrophila, and Pseudomonas species• Serious infections: tularemia (cats), herpes B virus (monkeys), rat-bite fever or sodoku (rats), hepatitis B virus (humans), leptospirosis (dogs and rodents), and rabies (dogs and other mammals)Microbiology• Human Bites: Staphylococcus aureus, Penicillin-resistant Gram-negative rods, alone or in mixed cultures, have been reported in 24% to 43% of cultured human bite wounds, anaerobic bacteria have been recovered from human bites in adults and children (50%)Document Outline
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ
  • ÿ