Bites Flashcards
1
Q
Main Considerations
A
- Penetrating injuries often involving vulnerable structures (i.e. hands)
- Altered microbiology of wounds
2
Q
Aetiology
A
- Staphylococci and streptococci still common
- Anaerobic organisms also common
- Pasteurella and capnocytophagia from mammal bites
3
Q
Signs & Symptoms
A
- Signs/symptoms include circumstances of animal bite, wound description, erythema, induration, fluctuance, purulent drainage, regional adenopathy and necrotic tissue.
- Risk factors include age <14 years, pet ownership and high-risk occupations.
4
Q
Investigations
A
- Wound cultures
o Growth of pathogenic organisms - X-ray
o Bony injury
5
Q
Treatment
A
- Antibiotic treatment:
o 1st line – Co-amoxiclav
o 2nd line – Doxycycline and metronidazole - Surgical treatment:
o Need to consider early exploration and debridement of complications, i.e. tendon sheath infection - Prophylactic treatment:
o Antibiotics for high risk injuries
o Consideration of tetanus prophylaxis
o Rabies prophylaxis if rabies cannot be excluded – bat scratches/bites only in the UK
6
Q
Complications
A
- Deep structure damage
- Abscess formation
- Osteomyelitis
- Endocarditis
- Septic arthritis
- Sepsis
7
Q
Prevention & Prognosis
A
- Primary prevention
o Animal control
o Bite reporting
o Public and owner never education (i.e. approach unfamiliar dogs) - Prognosis
o Dependent on wounds – minor have excellent recovery, more complicated can have higher morbidity although mortality is uncommon.