Shark bite
Background
- White shark (Carcharodon carcharias), tiger shark (Galeocerdo curvier) appear to be disposed to human attacks than other species
- Approximately 70-100 shark attacks worldwide per year and 5-15 deaths
Clinical Features
- Direct traumatic effects depend on size and species of shark
- Typically, attack appendages of victims
- In 70% on surface swimmers, only the lower limb is involved
- Upper limb may be injured when the victim attempts to fight off the attack
- Massive tissue injury
- Substantial tissue loss from stripping mechanism and extremity amputation are common
- Hemorrhagic shock
- Extremely high incidence of contamination with atypical microorganisms leading to wound infections
- Death is usually due to lack of prehospital resuscitation, hemorrhagic shock, or drowning
Work up
- Plain radiographs of all injured areas to identify fractures, periosteal stripping, retained foreign bodies (e.g. teeth)
- Wound cultures