Mammalian bites: Difference between revisions

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==Differential Diagnosis==
==Differential Diagnosis==
{{Bites and stings DDX}}


==Treatment==
==Treatment==

Revision as of 14:23, 11 March 2015

Background

  • 5% of untreated dog bites will become infected (similar to rate of non-bite wounds)
  • 80% of untreated cat bites will become infected
  • Human Bite: Closed fist infection

High-Risk Wounds

  • Cat, human, livestock, or monkey bites
  • Deep puncture wounds
  • Hand or foot wounds
  • Bites in immunosuppressed patients

Clinical Presentation

Workup

  • Normally clinical diagnosis (no workup)
  • Consider xray if possible retained tooth

Differential Diagnosis

Envenomations, bites and stings

Treatment

Indications for Primary Closure of Mammalian Bites

  • Consider closure if all of the following are true:
    • Not a face or scalp wound
    • Repair can occur within 6hr of injury (time dependent upon individual judgment)
    • Repair only requires single-layer closure; no devitalized tissue
    • No underlying fracture
    • No systemic immunocompromising conditions

Antibiotics

  • Consider for high-risk wounds (see above)

Mamallian bites:

Fish bites:

  • Fluoroquinolone (for Vibrio coverage)
  • Rabies immune globulin should be inidividualized[3]
    • Indicated for bites from bats, monkeys, skunks, raccoons, foxes. In the U.S. rare for dog and cat bites

See Also

Sources

  1. Griego RD, Rosen T, Orengo IF, Wolf JE. Dog, cat, and human bites: a review. J Am Acad Dermatol. 1995;33:1019–29.
  2. Talan DA, Citron DM, Abrahamian FM, Moran GJ, Goldstein EJ. Bacteriologic analysis of infected dog and cat bites. Emergency Medicine Animal Bite Infection Study Group. N Engl J Med. 1999;340:85–92.
  3. Human rabies—Washington, D.C., 1995. MMWR Morb Mortal Wkly Rep. 1995;44:625–7.