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Seemingly inconsequential yet catastrophic: the importance of wound washout with minute depressed skull fracture from a dog bite

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Abstract

Depressed skull fractures from dog bites are common pediatric head injuries which are contaminated with native skin and canine oral flora. Outcomes can potentially be catastrophic. Thus, these injuries require proper initial management to prevent future complications. We present an 18-month-old female who was bitten by a Great Dane dog and resulted in a small left temporal depressed skull fracture with an underlying brain contusion. This was initially treated conservatively with antibiotics and bedside irrigation. Five weeks later, she developed a large multiloculated abscess with mass effect, which required surgical aspiration and wound debridement. After long-term antibiotics, she made a full neurologic recovery. Our case illustrates the importance of washing out a seemingly inconsequential depressed skull fracture from a dog bite to avoid development of a cerebral abscess.

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Authors and Affiliations

  1. Section of Pediatric Neurosurgery, Department of Neurological Surgery, Riley Hospital for Children, Indiana University School of Medicine, 705 Riley Hospital Drive, Rm 1601C, Indianapolis, IN, 46202, USA

    Josue D. Ordaz, Salma M. Bakr & Jeffrey S. Raskin

  2. School of Medicine, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA

    Nichole H. Chicoine

  3. Section of Pediatric Infectious Disease, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA

    John J. Manaloor

  4. Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Salma M. Bakr

Authors
  1. Josue D. Ordaz
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  2. Nichole H. Chicoine
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  3. John J. Manaloor
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  4. Salma M. Bakr
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  5. Jeffrey S. Raskin
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Correspondence to Jeffrey S. Raskin.

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Ordaz, J.D., Chicoine, N.H., Manaloor, J.J. et al. Seemingly inconsequential yet catastrophic: the importance of wound washout with minute depressed skull fracture from a dog bite. Childs Nerv Syst 38, 669–672 (2022). https://doi.org/10.1007/s00381-021-05239-z

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  • DOI: https://doi.org/10.1007/s00381-021-05239-z

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