Lecture 4: Bites - Animal and Human Flashcards
Bite management?
tx of local infection
prevent/manage systemic illness
irrigate + debride
radiology if retained foreign bodies
What is primary laceration and indications for primary closure?
a primary laceration is one that is less than 6 hours old
indications for primary closure: <6 hrs, face/scalp wound, no devitalized tissue, no open fx laceration, no immunocompromised pt
What is a delayed laceration?
what care is given?
f/u instructions?
contaminated bites
wound is more than 6 hours old!
have to clean + debride + dress wounds w a non-adherent wound dressing
follow up in 24-48 hours !!
What type of bites characterized as high risk wounds?
bites from humans, cats, livestock and monkeys
l o l
but
esp bites in immunocompromised pts
What is something to be weary of from a human bite?
human bites cause local infections and can transmit systemic diseases d/t polymicrobial saliva (more serious)
Occlusion bite
Clenched/closed fist bites
-Occlusion bites = MC !
teeth marks
someone bites you, breaks skin surface
-Clenched/closed fist bites
when fist meets teeth… more serious injuries like
knuckle damage or infection in joints, tendon, bones and tendinitis
What organisms are associated with human bites?
Eikenella corodens
tx = augmentin
Staphylococci MC
tx = augmentin
Streptococci MC
tx = augmentin
Herpes simplex (herpetic whitlow)
tx = acyclovir, valacyclovir
What is Herpetic Whitlow?
where do you see it ?
what kind of pt/population?
how does it look?
signs and symptoms?
how to treat?
primary or recurrent HSV
infection of hands, rarely feet
usually seen in dental and medical personnel
1 or more small clear vesicles in finger pad area
pain out of proportion
edema
erythema
I&D is a NO. Contraindicated. can result in secondary bacterial infection
let the virus run its course, supportive treatment only
Common organism in dog bite?
tx?
Capnocytophaga cainmorsus
augmentin
rabies shot, tetanus prphylaxis
Common organism in cat bite?
Pasteurella multocida
&
Bartonella henselae
What disease is a/w Bartonella henselae ?
how do u dx?
symptoms?
treatment?
Cat scratch fever
by history! not easy to culture sooo..
painful regional lymphadenopathy,
fever, malaise, fatigue, headache, nausea, anorexia
tx = Azithromycin
What type of snake has triangular shaped heads w/ vertically elliptical pupils
effects?
how do u deal with a snake bite from this?
Crotalidae or pit vipers
have pitlike depression behind nostril
the venom enzymes digest tissue!
hematologic (thrombocytopenia, hemorrhage, coagulopathy)
systemic (metallic taste)
neurotoxic (confusion)
DO NOT do tourniquets, suck or cut the wound
mark swelling with a pen
observe for 8-12 hrs
discharge
What spider has red hourglass marks on ventral surface?
same questions as for snake
Black widow = Lacrodectus mactans
red spots at bite site that progress upward w systemic toxicity in 30-60 minutes
classic sx: myopathy
MC is abdominal wall spasm resembling surgical abdomen
then elevated CPK, issues w/ calcium
Treatment: Lacrodectus Antivenom and Benzo
What would be given to decrease cramping after a spider bite?
What would be give for muscle spasms after a spider bite?
What would be given after a black widow bite?
calcium gluconate
benzodiazepam
Lacrodectus antivenum
How do Elapidae:Coral snakes look?
does their venom cause local tissue damage?
red, yellow + black bands on entire body (red and yellow kill a fellow)
No, it’s neurotoxic
