When Animals Bite Flashcards
infection is likely after how many hours?
8
risk factors for biting dogs
terrier/herding breeds, pitbulls, rottwiler, german shepherds
sexually intact male dogs
purebred
low income neighborhoods
aggressive kids/owners
cat bites
less destructive but higher risk of infection (deeper puncture)
progress more rapidly to infection/abcess
more freq upper extremities
manifestations of cat bite v dog bite
cat - hands/upper extremities; deep abscess or osteomyelitis
dog - depressed/open skull fractures, severe scalp and intracranial bleeding; trauma
cat bite aerobes vs dog bite aerobes
cat = pasteurella, strep, staph, and moraxella
dog = pasteurella, strep, staph, and neisseria
cat bit anaerobes vs dog bite anaerobes
cat = fusobacterium, bacteriodes, porphyromonas
dog = fusobacterium, bacteriodes, porphyromonas, prevotella, and capnocytophagia
capnocytophagia
G-
anaerobe in dog bites
can cause sepsis in asplenic/immunocompromised people –> treat dog bite with cephalosporin
if a person presents with cat bite with penicillin allergy you treat with
metronidazole + ciprofloxacin
fluoroquinolones cover pasteurella (cipro)
pasteurella
nasopharynx of cats
15 hr incubation
local cellulitis and low grade fever can lead to absess, septic arthritis, osteomyelitis, pneumonia, endocarditis, and meningitis
sensitive to amox-clav (drug of choice is B-lactam + inhibitor), azithromycin
DOES NOT respond to erythromycin or clindamycin
capnocytophaga canimorsus
in dog bites
Severe infection in immunocompromised
treat w 3rd gen ceph
first part of care management
aggressive cleaning/irrigation!!
cleaning + elevate + antibiotics
oral abx drug of choice for dog bite
amoxicillin-clavulanate
clindamycin doesnt cover against
pasteurella
cat scratch disease
caused by bartonella henselae after a bite or scratch from a cat –> papule/pustule develops, fever, and enlarged tender LNs 1-3 weeks after
kids in fall/winter
rarely progresses to complications
cat scratch disease
bartonella henselae
treatment for cat scratch disease?
Z pack - azithromycin
treatment for human bites
amoxicillin-clavulanate
eikenella corrodens
anaerobic Gram neg. bacilli
common in human bites
resistant to: cephalexin, clindamycin, erythromycin, and metronidazole
sensitive to: penicillins (amox-clav), fluoroquinolones, tmp/smx, doxycycline
big cats bite
pasteurella present
rapid onset cellulitis –> deep structure involvement
acinetobacter baumanii
environmental pathogen; seen in wounded warriers overseas
gram - bacillus
treat with amox-sulbactam and colistin
rat bite fever
caused by streptobacillus moniliformis or spirillum minus
branching gram neg bacilli that causes pustular rash
risks: kids, pet shops, poor areas, labs
symptoms: relapsing fever, rash, migratory polyarthralgias –> can lead to endocarditis
treat with a penicillin (amox-clav) or doxycycline
mycobacterium marinum
fresh and salt water tanks or pools
granuloma from a minor injury or abrasion with cleaning fish tank
causes cutaneous lesions: soft papules, pustules, and ulcers weeks afterwards
vibrio vulnificus
due to shellfish or saltwater/brackish water
**filter feeding fish concentrate the bacteria
severe disease in people with liver disease, hemochromatosis, or alcohol abuse
treat with doxy + ceftriaxone
snake bites
**bacterial infections are rare since venom is sterile
when treating, DO NOT make local incision, suck the venom out, tourniquet the extremity, or place ice packs
treatment for snake bites
ceftriaxone and B-lactamase inhibitors as empiric abx
monkey bites can carry…
herpes B virus
herpes B virus from monkey
- Endemic among macaque monkeys
- Persists in sensory ganglia for lifetime, reactivates
- Incubation 5-21 days
- Vesicular lesion, paresthesias –> Seizures, ascending paralysis, respiratory failure
treat w valacyclovir or use acyclovir if woman is pregnant
rabies 3 phases
- 1st phase: Flu-like illness; Discomfort, prickling/pruritic sensation at bite
- 2nd phase: anxiety, confusion, agitation; insomnia, hydrophobia
- 3rd phase: Coma, death
tetanus
- pathogen is Clostridium tetani
- Environmental pathogen: soil, dust, manure
Spores enter via wound or breach in skin –> Disseminate toxin that acts within CNS
–Toxin interferes with neurotransmitter release, blocking inhibitor impulses
–Unopposed muscle contraction, spasm
presents as painful muscular contractions (lock jaw) and rigidity, spasms, and seizures
treatment = tetanus immune globulin (TIG), tetanus toxoid booster, relaxant to control muscles, and abx
if suspect pasteurella species as infection, do not
treat with clindmycin alone!
