BITES Flashcards
Human/animal bites
Human and animal bites that cause a break in the skin are an infection risk.
Assessment of pt with human/animal bite
risk of tetanus, rabies, or a blood-borne viral infection (such as HIV, and hepatitis B and C),
When would you refer a bite to the hospital?
- severe cellulitis, abscess, osteomyelitis, septic arthritis, necrotising fasciitis, or sepsis)
- or a penetrating wound involving the arteries, joints, nerves, muscles, tendons, bones or the central nervous system.
When would you offer abx prophylaxis
- cat or human: broken skin + drawn blood
- dog or other: broken skin + drawn blood if it has: penetrated bone, joint, tendon, deep, visibly contaminated
When would you CONSIDER abx prophylaxis
- cat bite: broken skin but not drawn blood and wound could be deep
- human: broken skin but not drawn blood
- dog: broken skin + drawn blood if it involves high risk area or comorbidity = increased risk of serious wound infection
Human and animal bites: 1st line treatment
Co-amoxiclav
Human and animal bites: 2nd line treatment
e.g. penicillin allergy
Doxycycline and metronidazole
Doxy = broad
Metro = fights other bacteria
Duration of prophylaxis
3 days - if there is no sign of infection yet
Duration of treatment
5 days
Lyme disease
It is transmitted to humans by the bite of an infected tick.
Most tick bites do not cause Lyme disease, and the prompt and correct removal of the tick reduces the risk of infection.
Symptons of Lyme disease
- erythema migrans rash
- usually 1–4 weeks after a tick bite, but can appear from 3 days to 3 months,
- non-focal (non-organ related) symptoms: fever, swollen glands, malaise, fatigue, neck pain or stiffness, joint or muscle pain, headache, cognitive impairment, or paraesthesia.
Tick bites (Lyme disease): 1st line treatment
- Doxycycline (100mg BD)
Tick bites (Lyme disease): 2nd line treatment
- Amoxicillin
If both doxyxycline and amoxicillin unsuitable = azithromycin
Human/animal scratches
Flucloxacillin
