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General Medicine

Bites, Animal and Human

Kathryn Samai, PharmD, BCPS and Brian J. Kimbrell, MD, FACS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Animal bite rates vary by species: dogs (60–90%), cats (5–20%), rodents (2–3%), humans (2–3%), and (rarely) other animals, including snakes

  • System(s) affected: potentially any

Pediatri...

DIAGNOSIS

HISTORY

  • Detailed history of the incident (provoked or unprovoked); type/breed of animal; vaccine status

  • Site of the bite

  • Geographic setting

  • Underlying medical history

PHYSICAL EXAM

  • Dog bites

    • Hands ...

TREATMENT

GENERAL MEASURES

  • Complete and submit bite report per local policy.

  • Elevate the injured extremity to prevent swelling.

  • Contact local health department to determine rabies prevalence in biting sp...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Recheck for infection in 24 to 48 hours.

  • Daily follow-up for infections to ensure resolution

  • Base revisions of antibiotic therapy on culture resul...

REFERENCES

1
Aziz H, Rhee P, Pandit V, et al. The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds. J Trauma Acute Care Surg.  2015;78(3):641–648. [View A...

ADDITIONAL READING

  • Okonkwo U, Changulani M, Moonot P. Animal bites: practical tips for effective management. J Emerg Nurs.  2008;34(3):225–226. [View Abstract on OvidMedline]

  • World Health Organiza...

CODES

ICD10

  • S61.459A Open bite of unspecified hand, initial encounter

  • S01.85XA Open bite of other part of head, initial encounter

  • S20.97XA Other superficial bite of unspecified parts of thorax, initial e...

CLINICAL PEARLS

  • Cleanse, débride, and culture.

  • Antibiotic prophylaxis is recommended for human bites and high-risk wounds.

  • Consider rabies and tetanus vaccination.

  • Adjust antibiotic choice and duration o...

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venom: teeth marks of a poisonous snake (A) as compared with that of a non-poisonous snake (B)
venom: teeth marks of a poisonous snake (A) as compared with that of a non-poisonous snake (B)
FIGURE 26-1 Acquisition and courses of infection with Bartonella henselae.
FIGURE 26-1 Acquisition and courses of infection with Bartonella henselae.
FIGURE 64-1 Cellulitis of the toe. The infection began adjacent to the nail as a paronychia but spread proximally to involve the shaft of the toe as cellulitis.
FIGURE 64-1 Cellulitis of the toe. The infection began adjacent to the nail as a paronychia but spread proximally to involve the shaft of ...
FIG. 3.14. An infected dog bite.
FIG. 3.14. An infected dog bite.
FIG. 3.15. This child sustained a dog bite to the foot, which was sutured at another institution. On follow-up, he had both cellulites (A) and a phalangeal fracture (B), possibly complicated by osteomyelitis.
FIG. 3.15. This child sustained a dog bite to the foot, which was sutured at another institution. On follow-up, he had both cellulites (A) ...
FIG. 3.15. This child sustained a dog bite to the foot, which was sutured at another institution. On follow-up, he had both cellulites (A) and a phalangeal fracture (B), possibly complicated by osteomyelitis.
FIG. 3.15. This child sustained a dog bite to the foot, which was sutured at another institution. On follow-up, he had both cellulites (A) ...
FIG. 11.34. Orbital cellulitis. This young girl has erythema and edema in the periorbital area (A), which could be caused by either orbital or periorbital infection. However, she has limitation of the extraocular muscles, which characterizes orbital cellulitis, as shown when she is staring straight ahead (B) and gazing upward (C). D: A computed tomography scan of the orbits demonstrates a mass lesion along the medial wall of the orbit in a child with ethmoid sinusitis and orbital infection....
FIG. 11.34. Orbital cellulitis. This young girl has erythema and edema in the periorbital area (A), which could be caused by either orbital...
FIG. 11.36. Cellulitis of the knee. Cellulitis in this patient developed at the site of a minor wound (A). The child was presented with fever and lymphangitic streaking (B).
FIG. 11.36. Cellulitis of the knee. Cellulitis in this patient developed at the site of a minor wound (A). The child was presented with fev...
FIG. 11.38. Cellulitis of the hand. When this patient arrived at the emergency department, he had developed cellulitis, or wound infection, of the hand after the repair of a laceration that was secondary to a dog bite. In many cases, bite wounds of the extremities are not managed with primary closure because of the risk of infection, particularly with Pasteurella multocida. His sutures were removed to allow drainage he received and treatment with intravenous antibiotics.
FIG. 11.38. Cellulitis of the hand. When this patient arrived at the emergency department, he had developed cellulitis, or wound infection,...
FIG. 22.40. A: This 12-year-old girl had been bitten by her dog and later hospitalized for cellulitis that improved on intravenous antimicrobials. B: When the infection recurred, a radiograph was obtained that showed a fracture from the initial dog bite. The patient was treated for osteomyelitis, and the infection resolved.
FIG. 22.40. A: This 12-year-old girl had been bitten by her dog and later hospitalized for cellulitis that improved on intravenous antimicr...
FIG. 22.40. A: This 12-year-old girl had been bitten by her dog and later hospitalized for cellulitis that improved on intravenous antimicrobials. B: When the infection recurred, a radiograph was obtained that showed a fracture from the initial dog bite. The patient was treated for osteomyelitis, and the infection resolved.
FIG. 22.40. A: This 12-year-old girl had been bitten by her dog and later hospitalized for cellulitis that improved on intravenous antimicr...
Figure 14.28. A. Cellulitis. B. Erysipelas in a patient with Down syndrome.
Figure 14.28. A. Cellulitis. B. Erysipelas in a patient with Down syndrome.
FIG. 11.36. Cellulitis of the knee. Cellulitis in this patient developed at the site of a minor wound (A). The child was presented with fever and lymphangitic streaking (B).
FIG. 11.36. Cellulitis of the knee. Cellulitis in this patient developed at the site of a minor wound (A). The child was presented with fev...
Teeth marks of a poisonous snake (A) as compared with that of a non-poisonous snake (B).
Teeth marks of a poisonous snake (A) as compared with that of a non-poisonous snake (B).
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