Abstract
Millions of people throughout the world are bitten by animals each year. About 90 % of the bites are caused by dogs and cats, and infections are the most common complications. As children are the most frequently bitten subjects, pediatricians should provide parents with everything they need to know in order to confront the problem. However, this does not seem to be case and, as the treatment of bite wounds is frequently inappropriate and delayed, the risk of acute infection and sequelae is increased. The main aim of this review is to discuss the epidemiology, microbiology, and clinical characteristics of infections due to dog and cat bites in children, and suggest the best approach to their management. Analysis of the published literature shows that prompt treatment is necessary in order to reduce the risk of infection. The therapeutic measures include wound washing, specific prophylaxis (i.e., tetanus and/or rabies), and antibiotics in the case of immunocompromised patients or deep wounds (particularly if there is evidence of edema or crushing), facial bites, or any wound over a tendon or bone.
Similar content being viewed by others
References
MacBean CE, Taylor DM, Ashby K (2007) Animal and human bite injuries in Victoria, 1998–2004. Med J Aust 186:38–40
Steele MT, Ma OJ, Nakase J, Moran GJ, Mower WR, Ong S, Krishnadasan A, Talan DA; EMERGEncy ID NET Study Group (2007) Epidemiology of animal exposures presenting to emergency departments. Acad Emerg Med 14:398–403
The Humane Society of the United States. U.S. pet ownership statistics. Available online at: http://www.humanesociety.org/issues/pet_overpopulation/facts/pet_ownership_statistics.html. Accessed 22 Nov 2012
FEDIAF. The European Pet Food Industry (2010) Facts & figures. Available online at: http://www.fediaf.org/fileadmin/user_upload/facts_and_figures_2010.pdf. Accessed 22 Nov 2012
Beck AM, Jones BA (1985) Unreported dog bites in children. Public Health Rep 100:315–321
Centers for Disease Control and Prevention (CDC) (2003) Nonfatal dog bite-related injuries treated in hospital emergency departments—United States, 2001. MMWR Morb Mortal Wkly Rep 52:605–610
Quinlan KP, Sacks JJ (1999) Hospitalizations for dog bite injuries. JAMA 281:232–233
Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JL (2006) Dog and cat bites to the hand: treatment and cost assessment. J Hand Surg Am 31:468–473
Litovitz TL, Klein-Schwartz W, White S, Cobaugh DJ, Youniss J, Omslaer JC, Drab A, Benson BE (2001) 2000 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 19:337–395
Ashby K, Routley V, Stathakis V (1998) Enforcing legislative and regulatory injury prevention strategies. Hazard 34:1–59
Bernardo LM, Gardner MJ, O’Connor J, Amon N (2000) Dog bites in children treated in a pediatric emergency department. J Soc Pediatr Nurs 5:87–95
Cornelissen JMR, Hopster H (2010) Dog bites in The Netherlands: a study of victims, injuries, circumstances and aggressors to support evaluation of breed specific legislation. Vet J 186:292–298
Piaget J (1962) The stages of the intellectual development of the child. Bull Menninger Clin 26:120–128
Sodian B, Taylor C, Harris PL, Perner J (1991) Early deception and the child’s theory of mind: false trails and genuine markers. Child Dev 62:468–483
Davis AL, Schwebel DC, Morrongiello BA, Stewart J, Bell M (2012) Dog bite risk: an assessment of child temperament and child–dog interactions. Int J Environ Res Public Health 9:3002–3013
Racca A, Amadei E, Ligout S, Guo K, Meints K, Mills D (2010) Discrimination of human and dog faces and inversion responses in domestic dogs (Canis familiaris). Anim Cogn 13:525–533
Villar RG, Connick M, Barton LL, Meaney FJ, Davis MF (1998) Parent and pediatrician knowledge, attitudes, and practices regarding pet-associated hazards. Arch Pediatr Adolesc Med 152:1035–1037
Ostanello F, Gherardi A, Caprioli A, La Placa L, Passini A, Prosperi S (2005) Incidence of injuries caused by dogs and cats treated in emergency departments in a major Italian city. Emerg Med J 22:260–262
Talan DA, Citron DM, Abrahamian FM, Moran GJ, Goldstein EJ; Emergency Medicine Animal Bite Infection Study Group (1999) Bacteriologic analysis of infected dog and cat bites. N Engl J Med 340:85–92
Jaindl M, Grünauer J, Platzer P, Endler G, Thallinger C, Leitgeb J, Kovar FM (2012) The management of bite wounds in children—a retrospective analysis at a level I trauma centre. Injury 43:2117–2121
Smith PF, Meadowcroft AM, May DB (2000) Treating mammalian bite wounds. J Clin Pharm Ther 25:85–99
Westling K, Farra A, Cars B, Ekblom AG, Sandstedt K, Settergren B, Wretlind B, Jorup C (2006) Cat bite wound infections: a prospective clinical and microbiological study at three emergency wards in Stockholm, Sweden. J Infect 53:403–407
Taplitz RA (2004) Managing bite wounds. Currently recommended antibiotics for treatment and prophylaxis. Postgrad Med 116:49–52, 55–56, 59
Abrahamian FM (2000) Dog bites: bacteriology, management, and prevention. Curr Infect Dis Rep 2:446–453
Dire DJ (1992) Emergency management of dog and cat bite wounds. Emerg Med Clin North Am 10:719–736
Oehler RL, Velez AP, Mizrachi M, Lamarche J, Gompf S (2009) Bite-related and septic syndromes caused by cats and dogs. Lancet Infect Dis 9:439–447
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE; Child Health Epidemiology Reference Group of WHO and UNICEF (2012) Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 379:2151–2161
Blanton JD, Dyer J, McBrayer J, Rupprecht CE (2012) Rabies surveillance in the United States during 2011. J Am Vet Med Assoc 241:712–722
Davlin SL, Vonville HM (2012) Canine rabies vaccination and domestic dog population characteristics in the developing world: a systematic review. Vaccine 30:3492–3502
Thomas N, Brook I (2011) Animal bite-associated infections: microbiology and treatment. Expert Rev Anti Infect Ther 9:215–226
Ganiere JP, Escande F, Andre G, Larrat M (1993) Characterization of Pasteurella from gingival scrapings of dogs and cats. Comp Immunol Microbiol Infect Dis 16:77–85
Weber DJ, Hansen AR (1991) Infections resulting from animal bites. Infect Dis Clin North Am 5:663–680
Gaastra W, Lipman LJA (2010) Capnocytophaga canimorsus. Vet Microbiol 140:339–346
Brook I, Hunter V, Walker RI (1984) Synergistic effect of Bacteroides, Clostridium, Fusobacterium, anaerobic cocci, and aerobic bacteria on mortality and induction of subcutaneous abscesses in mice. J Infect Dis 149:924–928
Brook I (2003) Microbiology and management of human and animal bite wound infections. Prim Care 30:25–39
American Academy of Pediatrics (AAP) (2009) Bite wounds. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS (eds) Red book: 2009 report of the Committee on Infectious Diseases, 28th edn. American Academy of Pediatrics (AAP), Elk Grove Village, pp 187–191
Warrell MJ (2012) Current rabies vaccines and prophylaxis schedules: preventing rabies before and after exposure. Travel Med Infect Dis 10:1–15
World Health Organisation (WHO) (2010) Rabies vaccines: WHO position paper. Wkly Epidemiol Rec 85:309–320
Rupprecht CE, Briggs D, Brown CM, Franka R, Katz SL, Kerr HD, Lett SM, Levis R, Meltzer MI, Schaffner W, Cieslak PR; Centers for Disease Control and Prevention (CDC) (2010) Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 59(RR-2):1–9
Cummings P (1994) Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials. Ann Emerg Med 23:535–540
Medeiros I, Saconato H (2001) Antibiotic prophylaxis for mammalian bites. Cochrane Database Syst Rev 2:CD001738
Moore F (1997) “I’ve just been bitten by a dog”. BMJ 314:88–90
Goldstein EJ (1994) Selected nonsurgical anaerobic infections: therapeutic choices and the effective armamentarium. Clin Infect Dis 18(Suppl 4):S273–S279
Goldstein EJ, Citron DM (1988) Comparative activities of cefuroxime, amoxicillin–clavulanic acid, ciprofloxacin, enoxacin, and ofloxacin against aerobic and anaerobic bacteria isolated from bite wounds. Antimicrob Agents Chemother 32:1143–1148
Wu PS, Beres A, Tashjian DB, Moriarty KP (2011) Primary repair of facial dog bite injuries in children. Pediatr Emerg Care 27:801–803
Morgan M, Palmer J (2007) Dog bites. BMJ 334:413–417
Bass JW, Freitas BC, Freitas AD, Sisler CL, Chan DS, Vincent JM, Person DA, Claybaugh JR, Wittler RR, Weisse ME, Regnery RL, Slater LN (1998) Prospective randomized double blind placebo-controlled evaluation of azithromycin for treatment of cat-scratch disease. Pediatr Infect Dis J 17:447–452
Margileth AM (1992) Antibiotic therapy for cat-scratch disease: clinical study of therapeutic outcome in 268 patients and a review of the literature. Pediatr Infect Dis J 11:474–478
Acknowledgments
This review was supported by a grant from the Italian Ministry of Health (Bando Giovani Ricercatori 2007), Italy.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Esposito, S., Picciolli, I., Semino, M. et al. Dog and cat bite-associated infections in children. Eur J Clin Microbiol Infect Dis 32, 971–976 (2013). https://doi.org/10.1007/s10096-013-1840-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-013-1840-x