Alligator and crocodile attacks - Revision history

Danbot: Remove refs with incorrect PMIDs (verified against PubMed)

2026-03-22T10:24:57Z

Remove refs with incorrect PMIDs (verified against PubMed)

← Older revision		Revision as of 10:24, 22 March 2026
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	==Clinical Features==		==Clinical Features==
	*Usually sudden attacks that catch the human by surprise.~~<ref>Caldicott DG, et al. Crocodile attack in Australia: an analysis of its incidence and review of pathology and management. Wilderness Environ Med. 2005;16(3):143-159. PMID 16209471</ref>~~		*Usually sudden attacks that catch the human by surprise.
	*Can produce large [[crush injuries]], punctures, and [[lacerations]].		*Can produce large [[crush injuries]], punctures, and [[lacerations]].
	*Delayed presentations can have polymicrobial [[skin infections\|infections]], which can cause serious deformity, [[sepsis]], and even death.		*Delayed presentations can have polymicrobial [[skin infections\|infections]], which can cause serious deformity, [[sepsis]], and even death.

Danbot: Add peer-reviewed reference

2026-03-22T10:16:41Z

Add peer-reviewed reference

← Older revision		Revision as of 10:16, 22 March 2026
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	==Clinical Features==		==Clinical Features==
	*Usually sudden attacks that catch the human by surprise.		*Usually sudden attacks that catch the human by surprise.<ref>Caldicott DG, et al. Crocodile attack in Australia: an analysis of its incidence and review of pathology and management. Wilderness Environ Med. 2005;16(3):143-159. PMID 16209471</ref>
	*Can produce large [[crush injuries]], punctures, and [[lacerations]].		*Can produce large [[crush injuries]], punctures, and [[lacerations]].
	*Delayed presentations can have polymicrobial [[skin infections\|infections]], which can cause serious deformity, [[sepsis]], and even death.		*Delayed presentations can have polymicrobial [[skin infections\|infections]], which can cause serious deformity, [[sepsis]], and even death.

ClaireLewis: /* Clinical Features */

2019-09-28T17:10:28Z

Clinical Features

← Older revision		Revision as of 17:10, 28 September 2019
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	*Usually sudden attacks that catch the human by surprise.		*Usually sudden attacks that catch the human by surprise.
	*Can produce large [[crush injuries]], punctures, and [[lacerations]].		*Can produce large [[crush injuries]], punctures, and [[lacerations]].
	*Delayed presentations can have polymicrobial infections, which can cause serious deformity, [[sepsis]], and even death.		*Delayed presentations can have polymicrobial [[skin infections\|infections]], which can cause serious deformity, [[sepsis]], and even death.

	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis: /* Management */

2019-09-24T17:51:43Z

Management

← Older revision		Revision as of 17:51, 24 September 2019
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	==Management==		==Management==
	* ABCs		* ABCs
	* Analgesia and/or regional anesthesia		* [[Analgesia]] and/or regional anesthesia
	===Wound Care===		===Wound Care===
	* Hemostasis		* Hemostasis

ClaireLewis at 15:19, 8 September 2019

2019-09-08T15:19:24Z

← Older revision		Revision as of 15:19, 8 September 2019
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	==Background==		==Background==
	===Reptilian Order ''Crocodylia'' Families===		===Reptilian Order ''Crocodylia'' Families===
			[[File:American alligator.jpeg\|thumb\|American Alligator]]
			[[File:Crocodile.jpeg\|thumb\|Crocodile]]

	*Alligatoridae (8 species, including alligators and caimans)		*Alligatoridae (8 species, including alligators and caimans)
	*Crocodylidae (14 species, including the true crocodiles)		*Crocodylidae (14 species, including the true crocodiles)

Rossdonaldson1: /* Empirical antibiotic coverage */

2018-05-12T20:11:45Z

Empirical antibiotic coverage

← Older revision		Revision as of 20:11, 12 May 2018
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	===Empirical [[antibiotic]] coverage===		===Empirical [[antibiotic]] coverage===
	**First line: [[fluoroquinolone]] or third-generation [[cephalosporin]]		*First line: [[fluoroquinolone]] or third-generation [[cephalosporin]]
	**Second line: [[trimethoprim-sulfamethoxazole]] or [[carbapenem]]		*Second line: [[trimethoprim-sulfamethoxazole]] or [[carbapenem]]
	** In wounds presenting with hemorrhagic bullae or necrosis, [[Vibrio]] species should be considered and the wound treated with surgical drainage and [[doxycycline]], [[fluoroquinolone]], [[carbapenem]], or other appropriate [[antibiotic]].		* In wounds presenting with hemorrhagic bullae or necrosis, [[Vibrio]] species should be considered and the wound treated with surgical drainage and [[doxycycline]], [[fluoroquinolone]], [[carbapenem]], or other appropriate [[antibiotic]].

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2018-05-12T20:10:39Z

Management

← Older revision		Revision as of 20:10, 12 May 2018
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	* ABCs		* ABCs
	* Analgesia and/or regional anesthesia		* Analgesia and/or regional anesthesia
			===Wound Care===
	* Hemostasis		* Hemostasis
	* Aggressive debridement and irrigation		* Aggressive debridement and irrigation
	* Empirical [[antibiotic]] coverage		* Injuries close to a joint should be considered open until proved otherwise, with orthopedic consultation for possible exploration and cleansing.
			* Areas of concern for compartment syndrome, with associated symptoms and signs of increased pain, tense compartments, and decreased circulation or temperature, should be evaluated with tissue manometry.
			* After exploration, irrigation, and debridement, bite wounds should preferably be left open because they are typically crush wounds or deep lacerations with significant bacterial contamination and surrounding soft tissue trauma. Cosmetically sensitive areas should be copiously irrigated and referred for delayed closure after 5 days of antibiotic therapy.

			===Empirical [[antibiotic]] coverage===
	**First line: [[fluoroquinolone]] or third-generation [[cephalosporin]]		**First line: [[fluoroquinolone]] or third-generation [[cephalosporin]]
	**Second line: [[trimethoprim-sulfamethoxazole]] or [[carbapenem]]		**Second line: [[trimethoprim-sulfamethoxazole]] or [[carbapenem]]
	** In wounds presenting with hemorrhagic bullae or necrosis, Vibrio species should be considered and the wound treated with surgical drainage and doxycycline, fluoroquinolone, carbapenem, or other appropriate antibiotic.		** In wounds presenting with hemorrhagic bullae or necrosis, [[Vibrio]] species should be considered and the wound treated with surgical drainage and [[doxycycline]], [[fluoroquinolone]], [[carbapenem]], or other appropriate [[antibiotic]].
	* Injuries close to a joint should be considered open until proved otherwise, with orthopedic consultation for possible exploration and cleansing. Areas of concern for compartment syndrome, with associated symptoms and signs of increased pain, tense compartments, and decreased circulation or temperature, should be evaluated with tissue manometry.
	* After exploration, irrigation, and debridement, bite wounds should preferably be left open because they are typically crush wounds or deep lacerations with significant bacterial contamination and surrounding soft tissue trauma. Cosmetically sensitive areas should be copiously irrigated and referred for delayed closure after 5 days of antibiotic therapy.

	==Disposition==		==Disposition==

Rossdonaldson1 at 20:09, 12 May 2018

2018-05-12T20:09:02Z

← Older revision		Revision as of 20:09, 12 May 2018
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	==Evaluation==		==Evaluation==
	* ABCs
	* Examine patient head to toe for other injuries		* Examine patient head to toe for other injuries
			* Radiographs to assess for underlying fractures or tooth fragments

	==Management==		==Management==
			* ABCs
	* Analgesia and/or regional anesthesia		* Analgesia and/or regional anesthesia
	* Hemostasis		* Hemostasis
	* Aggressive debridement and irrigation		* Aggressive debridement and irrigation
	* Radiographs to assess for underlying fractures or tooth fragments		* Empirical [[antibiotic]] coverage
	* Empirical antibiotic coverage ~~with a~~ fluoroquinolone or third-generation cephalosporin		**First line: [[fluoroquinolone]] or third-generation [[cephalosporin]]
	* ~~If patient is allergic to cephalosporin, also consider~~ trimethoprim-sulfamethoxazole or carbapenem.		**Second line: [[trimethoprim-sulfamethoxazole]] or [[carbapenem]]
	* In wounds presenting with hemorrhagic bullae or necrosis,Vibrio species should be considered and the wound treated with surgical drainage and doxycycline, fluoroquinolone, carbapenem, or other appropriate antibiotic.		** In wounds presenting with hemorrhagic bullae or necrosis, Vibrio species should be considered and the wound treated with surgical drainage and doxycycline, fluoroquinolone, carbapenem, or other appropriate antibiotic.
	* Injuries close to a joint should be considered open until proved otherwise, with orthopedic consultation for possible exploration and cleansing. Areas of concern for compartment syndrome, with associated symptoms and signs of increased pain, tense compartments, and decreased circulation or temperature, should be evaluated with tissue manometry.		* Injuries close to a joint should be considered open until proved otherwise, with orthopedic consultation for possible exploration and cleansing. Areas of concern for compartment syndrome, with associated symptoms and signs of increased pain, tense compartments, and decreased circulation or temperature, should be evaluated with tissue manometry.
	* After exploration, irrigation, and debridement, bite wounds should preferably be left open because they are typically crush wounds or deep lacerations with significant bacterial contamination and surrounding soft tissue trauma. Cosmetically sensitive areas should be copiously irrigated and referred for delayed closure after 5 days of antibiotic therapy.		* After exploration, irrigation, and debridement, bite wounds should preferably be left open because they are typically crush wounds or deep lacerations with significant bacterial contamination and surrounding soft tissue trauma. Cosmetically sensitive areas should be copiously irrigated and referred for delayed closure after 5 days of antibiotic therapy.

	==Disposition==		==Disposition==
	* Patients ~~who develop~~ cellulitis or signs of sepsis should be admitted to the hospital and treated aggressively.		* Patients with [[cellulitis]] or signs of [[sepsis]] should be admitted to the hospital and treated aggressively.
	* Patients with severe trauma should be admitted for further evaluation and management. Only minor wounds and patients with comprehensive plans for follow-up should be managed on an outpatient basis.		* Patients with severe trauma should be admitted for further evaluation and management. Only minor wounds and patients with comprehensive plans for follow-up should be managed on an outpatient basis.
	* Injuries causing significant trauma to the hands, face, and genitalia may require specialty surgical consultation.		* Injuries causing significant trauma to the hands, face, and genitalia may require specialty surgical consultation.

Rossdonaldson1: /* Clinical Features */

2018-05-12T20:06:24Z

Clinical Features

← Older revision		Revision as of 20:06, 12 May 2018
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	==Clinical Features==		==Clinical Features==
	*Usually sudden attacks that catch the human by surprise.		*Usually sudden attacks that catch the human by surprise.
	*Can produce large crush injuries, punctures, and lacerations.		*Can produce large [[crush injuries]], punctures, and [[lacerations]].
	*Delayed presentations can have polymicrobial infections, which can cause serious deformity, sepsis, and even death.		*Delayed presentations can have polymicrobial infections, which can cause serious deformity, [[sepsis]], and even death.

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1 at 20:05, 12 May 2018

2018-05-12T20:05:40Z

← Older revision		Revision as of 20:05, 12 May 2018
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	==Background==		==Background==
	*Crocodilian attacks are usually sudden and will catch the human subject by surprise.		===Reptilian Order ''Crocodylia'' Families===
			*Alligatoridae (8 species, including alligators and caimans)
	*~~Crocodiles, alligators, and caimans all belong within the reptilian order Crocodylia, comprising a total of 23 species separated into three families:~~ Alligatoridae (~~with eight~~ species, including alligators and caimans), Crocodylidae (14 species, including the true crocodiles)~~, and~~ Gavialidae (the Indian gharial).		*Crocodylidae (14 species, including the true crocodiles)
			*Gavialidae (1 species, the Indian gharial).

	===Epidemiology===		===Epidemiology===
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	==Clinical Features==		==Clinical Features==
	~~Crocodilian bites can~~ produce large crush injuries, punctures, and lacerations. ~~Polymicrobial~~ infections ~~have~~		*Usually sudden attacks that catch the human by surprise.
	~~been found frequently to~~ cause serious deformity, sepsis, and even death.		*Can produce large crush injuries, punctures, and lacerations.
			*Delayed presentations can have polymicrobial infections, which can cause serious deformity, sepsis, and even death.

	==Differential Diagnosis==		==Differential Diagnosis==