Mammalian bites: Difference between revisions
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*Hand or foot wounds | *Hand or foot wounds | ||
*Bites in immunosuppressed patients | *Bites in immunosuppressed patients | ||
==Clinical Presentation== | |||
==Workup== | |||
*Normally clinical diagnosis (no workup) | |||
*Consider xray if possible retained tooth | |||
==Differential Diagnosis== | |||
==Treatment== | ==Treatment== | ||
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**No systemic immunocompromising conditions | **No systemic immunocompromising conditions | ||
===Antibiotics=== | ===[[Antibiotics]]=== | ||
*Consider for high-risk wounds (see above) | *Consider for high-risk wounds (see above) | ||
'''Mamallian bites:''' | '''Mamallian bites:''' | ||
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*[[Doxycycline]] 100mg daily x 14 days if penicillin allergic <ref>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.</ref> | *[[Doxycycline]] 100mg daily x 14 days if penicillin allergic <ref>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.</ref> | ||
'''Fish bites:''' | '''Fish bites:''' | ||
*Fluoroquinolone (for Vibrio coverage) | *[[Fluoroquinolone]] (for [[Vibrio]] coverage) | ||
*Rabies immune globulin should be inidividualized<ref>Human rabies—Washington, D.C., 1995. MMWR Morb Mortal Wkly Rep. 1995;44:625–7.</ref> | *[[Rabies]] immune globulin should be inidividualized<ref>Human rabies—Washington, D.C., 1995. MMWR Morb Mortal Wkly Rep. 1995;44:625–7.</ref> | ||
**Indicated for bites from bats, monkeys, skunks, raccoons, foxes. In the U.S. rare for dog and cat bites | **Indicated for bites from bats, monkeys, skunks, raccoons, foxes. In the U.S. rare for dog and cat bites | ||
Revision as of 14:19, 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
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:
- Amoxicilin-clavulanate 875mg PO BID x 5-7d[1]
- Doxycycline 100mg daily x 14 days if penicillin allergic [2]
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
- ↑ Griego RD, Rosen T, Orengo IF, Wolf JE. Dog, cat, and human bites: a review. J Am Acad Dermatol. 1995;33:1019–29.
- ↑ 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.
- ↑ Human rabies—Washington, D.C., 1995. MMWR Morb Mortal Wkly Rep. 1995;44:625–7.