Animal bite

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Animal bite
Military working dog training to attack by biting
SpecialtyEmergency medicine Edit this on Wikidata

An animal bite is a

ectoparasites from its body surface, removes plant seeds attached to its fur or hair, scratching itself, and grooming other animals. Animal bites often result in serious infections and mortality. Animal
bites not only include injuries from the teeth of reptiles, mammals, but fish, and amphibians. Arthropods can also bite and leave injuries.

Signs and symptoms

Bite wounds can cause a number of signs and symptoms

Classification

Bites are usually classified by the type of animal causing the wound. Many different animals are known to bite humans.

Vertebrates

Jaw of the piranha with biting equipment displayed

Involuntary

fist fights. These have been termed "fight bites". Injuries in which the knuckle joints or tendons
of the hand are bitten into tend to be the most serious.

Teething infants are known to bite objects to relieve pressure on their growing teeth, and may inadvertently bite people's hands or arms while doing so. Young children may also bite people out of anger or misbehaviour, although this is usually corrected early in the child's life.

Reverse bite injury

A reverse bite injury (also called a clenched fist injury, closed fist injury, or fight bite) results when a person punches another person in the face, and the skin (and sometimes tendons) of their knuckles are cut against the teeth of the person they are punching.[2] The proximity of the wound is often located over the metacarpophalangeal joint resulting in tendon injury.[3]

The medical treatment of this injury is similar to those of a

human bite, but may also involve damage of the underlying tendons.[4]

These injuries should be managed as other human bites: wound irrigation and

antibiotics are essential as human saliva can contain a number of bacteria.[5] The nature of these injuries is such that even if the injury is optimally managed, poor outcomes may still occur.[2]

Arthropods

The bites of arthropods have some of the most serious health consequences known. Mosquito bites transmit serious disease and result in millions of deaths and illnesses in the world. Ticks also transmit many diseases such as Lyme disease.

A mosquito bite

Mechanism

Trauma

A natural consequence of a bite is tissue trauma at the site. Trauma may consist of scratching, tearing, punture or laceration of the skin, hematoma (bruising), embedding of foreign objects, for example a tooth or hair, damage to or severing of underlying structures such as connective tissue or muscle, amputations, and the ripping off of skin and hair. If major blood vessels are damaged, severe blood loss can occur.[6]

Infection

Pathogen organisms can be introduced into the bite. Some of the pathogens can originate from the mouth of the 'biter', the substrate onto which the injured person or animal can fall or from the naturally occurring microorganisms that are present on the skin or hair of the animal. The advent of antibiotics improved the outcome of bite wound infections.[6]

Rabies

Animal bites where skin has been penetrated, most commonly by dogs and bats, transmit rabies to humans.[7] Rabies from other animals is rare.[7] If the animal is caught alive or dead with its head preserved, the head can be analyzed to detect the disease. Signs of rabies include foaming at the mouth, growling, self-mutilation, jerky behavior, red eyes, and hydrophobia.

If the animal cannot be captured, preventative rabies treatment is recommended in many places. Several countries are known not to have native rabies, see the Wikipedia page for prevalence of rabies.

Treatment

The first step in treatment includes washing the bite wound.

randomised controlled trials were needed to fully answer this question.[9]

Antibiotics

Antibiotics to prevent infection are recommended for dog and cat bites of the hand,[10] and human bites if they are more than superficial.[11] They are also recommended in those who have poor immune function.[8] Evidence for antibiotics to prevent infection in bites in other areas is not clear.[12]

The first choice is

amoxicillin with clavulanic acid, and if the person is penicillin-allergic, doxycycline and metronidazole.[11] The antistaphylococcal penicillins (e.g., cloxacillin, nafcillin, flucloxacillin) and the macrolides (e.g., erythromycin, clarithromycin) are not used for empirical therapy, because they do not cover Pasteurella species.[11]

Vaccinations

Rabies prevention is generally available in

Northern European
states.

Tetanus immune globulin
is indicated in people with more than 10 years since prior vaccination. Tetanus boosters (Td) should be given every ten years.

Prior toxoid Clean minor wounds All other wounds
< 3 doses TT: yes, TIG: no TT: yes, TIG: yes
≥ 3 doses TT: if last dose ≥ 10yr
TIG: no 		TT: if last dose ≥ 5yr, TIG: no

TT = tetanus toxoid; TIG: tetanus immune globulin

Mosquito bites

Main article:
Insect bites and stings

mosquitoes
.

Epidemiology

Human bites are the third most frequent type of bite after dog and cat bites.

Dog bites are commonplace, with children the most commonly bitten and the face and scalp the most common target.[14] About 4.7 million dog bites are reported annually in the United States.[15] The US estimated annual count of animal bites is 250,000 human bites, 1 to 2 million dog bites, 400,000 cat bites, and 45,000 bites from snakes. Bites from skunks, horses, squirrels, rats, rabbits, pigs, and monkeys may be up to 1 percent of bite injuries. Pet ferrets attacks that were unprovoked have caused serious facial injuries. Non-domesticated animals though assumed to be more common especially as a cause of rabies infection, make up less than one percent of reported bite wounds. When a person is bitten, it is more likely to occur on the right arm, most likely due to defensive reactions when the person uses their dominant arm. Estimates are that three-quarters of bites are located on the arms or legs of humans. Bites to the face of humans constitute only 10 percent of the total. Two-thirds of bite injuries in humans are suffered by children aged ten and younger.[6]

Up to three-fourths of dog bites happen to those younger than 20 years-old. In the United States, the costs associated with dog bites are estimated to be more than $1 billion annually. The age groups that suffer most from dog bites are children 5 to 9 years-old. Often, bites go unreported and no medical treatment given - these bites go unreported. As many as one percent of pediatric emergency room visits are for treatment for animal bites. This is more frequent during the summer months. Up to five percent of children receiving emergency care for dog bites are then admitted to the hospital. Bites typically occur in the late afternoon and early evening. Girls are bitten more frequently by cats than they are by dogs. Boys are bitten by dogs two times more often than girls are bitten by dogs.[6]

History

The bites of humans are recorded during the biblical era. Reports of secondary infection occurring after a human bite in children have been noted in the United States since at least 1910. Morbidity and mortality rates improved with the use of antibiotics.[6]

See also

References

  1. ISSN 2214-109X
    .
  2. ^
    PMID 11880877
    .
  3. PMID 17582031
    .
  4. PMID 25770897
    .
  5. PMID 14614671
    .
  6. ^
    ISBN 978-1-4557-1177-2.[page needed
    ]
  7. ^ a b "Rabies Fact Sheet N°99". World Health Organization. September 2014. Retrieved 10 January 2015.
  8. ^ a b c d "Animal bites Fact sheet N°373". World Health Organization. February 2013. Retrieved 5 May 2014.
  9. PMID 31805611
    .
  10. ^ "Antibiotics in cat bites". BestBets.
  11. ^
    PMID 19555903
    .
  12. PMID 11406003
    .
  13. ^ "BestBets: Oral antihistamines for insect bites".
  14. PMID 24436765
    .
  15. ^ Questions and Answers about Dog Bites Archived 4 March 2009 at the Wayback Machine

External links

Wikimedia Commons has media related to Animal bites.
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