Current Infectious Disease Reports

, Volume 5, Issue 5, pp 416–425 | Cite as

Bite wound infections

  • Joseph P. Myers
Article

Abstract

Patients with mammalian bite wounds account for hundreds of thousands of emergency department, urgent care center, and physician office visits in the United States each year. The types of wounds encountered by physicians range from insignificant scratches to life-threatening neck and facial injuries. Infectious complications of bite wounds are common, and the consequences of these infections are significant and sometimes disabling. This article reviews the infectious complications of cat, dog, and human bite wounds. The prevention of tetanus and rabies virus infection, the appropriate antimicrobial treatment of bacterial infections, and the frequent need for surgical consultation and intervention are emphasized.

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References and Recommended Reading

  1. 1.
    Weiss HB, Friedman DI, Coben JH: Incidence of dog bite injuries treated in emergency departments. JAMA 1998, 279:51–53.PubMedCrossRefGoogle Scholar
  2. 2.
    Goldstein EJ, Talan DA: Bite wounds. In Infectious Diseases. A Treatise of Infectious Processes, edn 5. Edited by Hoeprich PD and Jordan MC. Philadelphia: JB Lippincott Company; 1994:1420–1423.Google Scholar
  3. 3.
    Weber DJ, Hansen AR: Infections resulting from animal bites. Infect Dis Clin North Am 1991, 5:663–680.PubMedGoogle Scholar
  4. 4.
    McDonoug JJ, Stern PJ, Alexander JW: Management of animal and human bites and resulting human infections. Curr Clin Top Infect Dis 1987, 8:11–36.Google Scholar
  5. 5.
    Wahl RP, Eggleston J, Edlich R: Puncture wounds and animal bites. In Emergency Medicine. A Comprehensive Study Guide, edn 4. Edited by Tintinalli JE, Ruiz E, and Krome RL. New York: McGraw-Hill; 1996:317–322.Google Scholar
  6. 6.
    Bowman MJA: Animal bites in infants and children: an approach to diagnosis and treatment. Pediatr Emerg Med Rep 1999, 4:53–62. This is an excellent review of the necessary steps in the evaluation and management of pediatric bite wounds and has excellent clinical tips for specialists in emergency departments that are frequented by children.Google Scholar
  7. 7.
    Newton E: Mammalian bites. In Principles and Practice of Emergency Medicine, edn 3. Edited by Schwartz GR, Roth PB, and Cohen JS. Philadelphia: Lea & Febiger; 1992:2750–2761.Google Scholar
  8. 8.
    Goldstein EJ, Richwald GA: Human and animal bite wounds. Am Fam Physician 1987, 36:101–109.PubMedGoogle Scholar
  9. 9.
    Chretien JH, Garagusi VF: Infections associated with pets. Am Fam Physician 1990, 41:831–845.PubMedGoogle Scholar
  10. 10.
    Tan JS: Human zoonotic infections transmitted by dogs and cats. Arch Intern Med 1997, 157:1933–1943. This article is an excellent resource for the clinical evaluation and management of the zoonotic infections encountered in the United States and transmitted by the most common household pets (cats and dogs).PubMedCrossRefGoogle Scholar
  11. 11.
    Plaut M, Zimmerman EM, Goldstein RA: Health hazards to humans associated with domestic pets. Annu Rev Public Health 1996, 17:221–245.PubMedGoogle Scholar
  12. 12.
    Weber DJ, Weinberg AN: Animal-associated human infections. Infect Dis Clin North Am 1991, 5:1–181.Google Scholar
  13. 13.
    Goldstein EJ: Bites. In Mandel, Douglas and Bennett’s Principles and Practice of Infectious Diseases, edn 4. Edited by Mandell GL, Bennett JE, and Dolin R. New York: Churchill Livingstone; 1995:2765–2769.Google Scholar
  14. 14.
    Goldstein EJ: Bites. In Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, edn 5. Edited by Mandell GL, Bennett JE, and Dolin R. Philadelphia: Churchill Livingstone;. 2000:3202–3206. This is a meticulously prepared chapter for the diligent physician to use as a clinical reference and as a state-of-the-art guide of the microorganisms and antimicrobials associated with bite wound infections at the beginning of the 21st century.Google Scholar
  15. 15.
    Dire DJ: Cat bite wounds: risk factors for infection. Ann Emerg Med 1991, 20:973–979.PubMedCrossRefGoogle Scholar
  16. 16.
    Moran GJ, Talan DA: Hand infections. Emerg Med Clin North Am 1993, 11:601–619.PubMedGoogle Scholar
  17. 17.
    McGrath MH: Infections of the hand. In Plastic Surgery, vol 8. Edited by McCarthy JG, May JWJ, Littler JW. Philadelphia: WB Saunders Company; 1990:5529–5556.Google Scholar
  18. 18.
    Brook I: Human and animal bite infections. J Fam Pract 1989, 28:713–718.PubMedGoogle Scholar
  19. 19.
    Goldstein EJ: Human and animal bites. In Current Therapy of Infectious Disease. Edited by Schlossberg D. St. Louis: Mosby Year Book; 1996:66–68.Google Scholar
  20. 20.
    Edlich RF, Spengler MD, Rodeheaver GT: Mammalian bites. Compr Ther 1983, 9:41–47.PubMedGoogle Scholar
  21. 21.
    Callaham MLTreatment of common dog bites: infection risk factors. JACEP 1978, 7:83–87.PubMedGoogle Scholar
  22. 22.
    Talan DA, Citron DM, Abrahamian FM, et al.: Bacteriologic analysis of infected dog and cat bites. N Engl J Med 1999, 340:85–92. This is the best publication evaluating the microbiologic flora associated with bite wound infections. It provides the academician and the practitioner with the qualitative and quantitative information necessary to understand the broad spectrum of microorganisms implicated as pathogens in bite wound infections. It also provides the diagnostic microbiology required to aid the physician in choosing appropriate antimicrobial therapy in the management of patients with bite wound infections.PubMedCrossRefGoogle Scholar
  23. 23.
    Talan DA: Staphylococcus intermedius: clinical presentation of a new human dog bite pathogen. Ann Emerg Med 1989, 18:410–413.PubMedCrossRefGoogle Scholar
  24. 24.
    Goldstein EJ, Pryor EP III, Citron DM: Simian bites and bacterial infection. Clin Infect Dis 1995, 20:1551–1552.PubMedGoogle Scholar
  25. 25.
    Chambers GH, Payne JF: Treatment of dog bite wounds. Minn Med 1969, 52:427–430.PubMedGoogle Scholar
  26. 26.
    Diptheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Recomm Rep 1991, 40:1–28.Google Scholar
  27. 27.
    Human rabies prevention--United States, 1999. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 1999, 48:1–21.Google Scholar
  28. 28.
    Holmes GP, Chapman LE, Stewart JA, et al.: Guidelines for the prevention and treatment of B-virus infections in exposed persons. Clin Infect Dis 1995, 20:421–439.PubMedGoogle Scholar
  29. 29.
    Baker AS, Ruoff KL, Madoff S: Isolation of Mycoplasma species from a patient with seal finger. Clin Infect Dis 1998, 27:1168–1170.PubMedGoogle Scholar
  30. 30.
    Vidmar L, Poljak M, Tomazic J, et al.: Transmission of HIV-1 by human bite. Lancet 1996, 347:1762.PubMedCrossRefGoogle Scholar
  31. 31.
    HIV infection by a human bite. Infect Control Hosp Epidemiol 1996, 17:707.Google Scholar
  32. 32.
    Callaham ML: Prophylactic antibiotics in common dog bite wounds: a controlled study. Ann Emerg Med 1980, 9:410–414.PubMedCrossRefGoogle Scholar
  33. 33.
    Goldstein EJ, Citron DM, Merriam CV, et al.: Comparative in vitro activity of ertapenem and 11 other antimicrobial agents against aerobic and anaerobic pathogens isolated from skin and soft tissue animal and human bite wound infections. J Antimicrob Chemother 2001, 48:641–651.PubMedCrossRefGoogle Scholar
  34. 34.
    Goldstein EJ, Reinhardt JR, Murray PM, et al.: Animal and human bite wounds, a comparative study: augmentin vs. a penicillin + dicloxacillin. Postgrad Med J 1984, 60(Suppl):105–110.Google Scholar
  35. 35.
    Goldstein EJ, Citron DM, Hudspeth M, et al.: Trovafloxacin compared with levofloxacin, azithromycin and clarithromycin against unusual aerobic and anaerobic human and animal bite-wound pathogens. J Antimicrob Chemother 1998, 41:391–396.PubMedCrossRefGoogle Scholar
  36. 36.
    Goldstein EJ, Citron DM, Hudspeth M, et al.: In vitro activity of Bay 12-8039, a new 8-methoxyquinolone, compared to the activities of 11 other oral antimicrobial agents against 390 aerobic and anaerobic bacteria isolated from human and animal bite wound skin and soft tissue infections in humans. Antimicrob Agents Chemother 1997, 41:1552–1557.PubMedGoogle Scholar
  37. 37.
    Goldstein EJ, Citron DM, Merriam CV, et al.: Activity of gatifloxacin compared to those of five other quinolonoes versus aerobic and anaerobic isolates from skin and soft tissue samples of human and animal bite wound infections. Antimicrob Agents Chemother 1999, 43:1475–1479.PubMedGoogle Scholar
  38. 38.
    Goldstein EJ: Animal Bite Infections. In Skin, Soft Tissue, Bone, and Joint Infections. Edited by Stevens DL. Philadelphia: Churchill Livingstone; 1995:4.1–4.16.Google Scholar
  39. 39.
    Public health service guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. Centers for Disease Control and Prevention. MMWR Recomm Rep 1998, 47:1–34.Google Scholar

Copyright information

© Current Science Inc. 2003

Authors and Affiliations

  • Joseph P. Myers
    • 1
  1. 1.Summa Health SystemAkronUSA

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