Infection Emergencies Flashcards
When do most human bites occur?
During fights, although sport and sexual activity can also be a cause.
Other than human bites, what other bites are common?
Dog bites are most common, with cat bites also.
What is important to document when someone has been bitten?
- How and when it occured
- Location and appearance of bite
- Assess any damage underneath the bite
- Any increased risk of infection (e.g. DM, immunosuppression)
- Vaccination hx
What are the specific risks associated with human bites?
- BBV risk (Hep B, C, HIV)
- Circumstances including alcohol, domestic violence, non-accidental injury or child abuse.
What are the specific risks of animal bites?
- If bitten outside UK
- Domestic vs wild animal bite
- Rabies vaccination status if bitten outside UK
What is the best initial management for a bite wound?
Irrigation with warm water or normal saline
What management may a bite need?
- Prophylactic abx
- Referral to plastics
- Analgesia
- Wound closure
- Tetanus immuniation/Ig
When should prophylactic abx be prescribed for a bite?
- All cat bites
- All human bites less than 72 hours old
- All dog bites to face/hand/feet/genitals
- Pts at increased risk of infection
Which antibiotic is recommended first line for all domestic animal bites?
Co-amoxiclav for 5 days
OR
Doxycycline + metronidazole 5 days if pen-allergic
Is BBV transmission common after a human bite?
No - 20 times less common than in needle-stick injury.
How common is bite wound infection?
Very - up to 20% of dog bites, up to 80% of cat bites, and up to 50% of human bites.
What is necrotising fasciitis?
Uncommon life-threatening necrotising infection involving any layer of deep soft tissue compartment.
What might necrotising fasciitis mimic in the early stages?
Cellulitis
What is the main difference clinically between cellulitis and nec fasc?
Pain, tenderness, and systemic illness out of proportion to the localised physical signs.
Why does nec fasc need a high index of suspicion?
Prompt surgical debridement is necessary for best outcomes.
