Flashcards in When Animals Bite Deck (38)
Who is most likely to get bit by a dog?
9 year old boy
Who is most likely to get bit by a cat?
75 year of women
-60% of animal bites
-mostly young boys
-Inc in sexually intact male gods
- Inc in purebred status
-More often hand and face attacked
Type of dog that is #1 cause of human death?
Pit bull breed: Staffordshire terrier
1. Less destructive/life threatening
2. Deeper puncture wounds (may cause osteomyletis)
3. Inc risk of infection/soft tissue abscess (Rapid progression to infection)
4. More often upper extremities
Most common pathogens in Dog/care bite wound infections
1. Pasturella (cat>dogs)
2. Capnocytophagia canimorsus (dog>cat)
3. Anaerobes: Bacteroides, Fusobacteria, Porphyromonas, Prevotella
4. Skin flora: Staphylococci, Streptococci
Tell me about Pasturella structure?
Gm (-) bacilli, facultative anaerobe, catalase (+), oxidase (+)
What does it look like when stained? What do you grow it on?
Growth on 5% sheep’s blood agar.
Shows bipolar staining (safety pin like yersinia!)
Where do we get Pasturella from (soft ball)
Source: respiratory tract of cats and dogs. Transmission: BITES
Sx of Pasturella infection
soft tissue infections (cellulitis) w/in 24 hours of bite.
May develop into necrotizing fasciitis or osteomyelitis. Systemic spread (pneumonia, endocarditis, meningitis) and lymphadenopathy esp in those with COPD or liver dz.
Tx for Pasturella infections?
PCN + beta lactamase inhibitor (amoxicillin + clavulanate)
Tell me about Capnocytophaga canimorsus structure?
Where do we find Capnocytophaga canimorsus and how do we get it?
It's normal flora in dog>cats and we get it from bites
Management of animal bite wounds?
1. Irrigate the shit out of it, debridgement
2. X-rays to make sure surgical eval is not needed. Look for fractures.
3. Elevate extremity
5. Tetanus (if human bite)
When do you give antibiotic prophylaxis?
1. Deep puncture wounds
2. Crush injuries
3. Wounds involving venous/lymphatic compromise
4. Wounds close to hand/joint/bone
5. Wounds needing surgical repair
6. Immunocompromised pt
Go to drug for dog/cat bites?
What drugs should you avoid?
Alternative drugs if PCN allergy?
Fluoroquinolone+metronidazole or clindamycin
(DON'T USE CLINDAMYCIN ALONE--misses pasturella)
Pregnant lady with PCN allergy gets bit by a cat. NOOOOO! What do you treat her with??
Can't use PCN cuz of allergy
Can't use fluoroquinolones/metronidazole in pregnant ladies
Common pathogens transmitted through human bites
2. Anaerobes: Eikenella, Fusobacterium, Peptostreptococcus, Prevotella, Porphyromonas
3. Viral: HBV, HCV, HSV
Human bite should make you think of
Structure of Eikenella corrodens
Fastidious Gram(-) facultative anaerobic bacillus
Tx for Eikenella corrodens
PCN (amox/clav), fluoroquinolones, TMP/SMX, doxy
What bacteria is associated with bites in the Middle East?
Structure of Acinetobacter baumannii
Common infection from rats?
Structure of Streptobacillus moniliformis
Gm (-) branching bacilli
Who gets Streptobacillus moniliformis?
children, low SES, labs, pet shops
What does Streptobacillus moniliformis cause?
rat bite fever”: relapsing fever, pustular rash, migratory polyarthritis
Common complication: endocarditis