Human bite-induced penile ulceration: report of a case and review of literature

Human bite on genitalia is a rare cause of penile ulceration, but is increasingly being reported, probably due to the increasing frequency of orogenital sex. The great morbidity associated with it brings it under the category of high-risk bite wounds, similar to those on hands, feet and joints. We report a case and review the literature on human bite-induced penile ulceration.

Multifactorial analysis of the aetiology of craniomandibular dysfunction in children

OBJECTIVES

It is generally accepted that the aetiology of craniomandibular dysfunction (CMD) is multifactorial. Different types of malocclusion, oral parafunctions especially bruxism, trauma of the mandible or temporomandibular joint (TMJ) and emotional stress are known aetiologic factors. Research has been conducted into the relationship between each of these aetiologic factors and the signs and symptoms of CMD. However, such an approach does not control for the simultaneous effect of other factors responsible for the development of the dysfunction. The purpose of this study was to investigate the effect of each aetiologic factor on the signs and symptoms of CMD in children, controlling for the effect of all other known factors by means of a multifactorial analysis.

METHODS

A sample of 314 children, aged 6-8 years, was examined clinically for signs of CMD and morphologic and functional malocclusion. Symptoms of CMD and oral parafunctions were recorded by the same investigator in an interview. Emotional stress was measured through urinary catecholamines including epinephrine, norepinephrine and dopamine, detected in a 24-h urine sample, using high performance liquid chromatography. A questionnaire was distributed to the parents to collect information regarding socioeconomic factors and the history of dentofacial injuries. A logistic multiple regression was carried out to estimate the partial effect of each aetiologic factor. A 95% probability level was used.

RESULTS

Posterior crossbite with lateral shift significantly affected the probability of child developing deviation of the mandible on opening. Similarly, posterior crossbite and epinephrine had a significant impact on TMJ tenderness, overjet had an effect on clicking, clenching and biting of objects had an effect on muscle tenderness, and lip/cheek biting influenced dysfunctional opening. Of the symptoms reported, pain on wide opening was affected significantly by lip/cheek biting.

CONCLUSION

On the basis of these results, it can be suggested that parafunctional and some structural and psychological factors may increase the probability of the child developing the signs and symptoms of CMD.

Human bites of the hand: the Tasmanian experience

INTRODUCTION

The purpose of the present paper is to provide geographically representative information on the presentation, treatment and complications of human bites of the hand in Australia.

METHODS

A 5-year retrospective study was undertaken of patients treated at Royal Hobart Hospital for human bites of the hand. The variables evaluated included age, sex, hand involvement, anatomical distribution, presentation, operative findings, bacteriology, antibiotic use, X-ray findings, complications and compliance.

RESULTS

Thirty-five patients had human bites to the hand. All were male with a median age of 24 years. Most were clenched fist injuries with the middle metacarpophalyngeal joint being the most prone to injury. Patients presenting early had a high incidence of open joints and fractures but spent less time in hospital than late presenters, almost all who had infection complications. Compliance with treatment was found to be a major problem. Serious hand infections were not observed.

CONCLUSION

The treatment of human bites must be early, correct and comprehensive. The appropriate treatment is surgical exploration with debridement and lavage, appropriate antibiotic administration, hand elevation and initial immobilization. Poor compliance of patients in the present study was demonstrated by a high incidence of late presentation, self-discharge from hospital and loss to follow up, making assessment of outcomes difficult. Despite this there is an absence of serious hand infections reported in the literature and this may be due to the administration of antibiotics prior to referral.

Managing dog, cat, and human bite wounds

Many bite wound patients seek treatment in primary care clinics instead of emergency departments. Without treatment, bite wounds can become infected. Presenting symptoms are usually wound site pain with cellulitis and purulent drainage. The infection originates from the oropharyngeal flora of the biting animal or human and the victim's skin. Primary care clinicians must be able to assess and manage animal and human bites, initiate antibiotic therapy if indicated, and refer patients for surgery or rabies prophylaxis when appropriate. Prompt assessment and treatment can prevent most bite wound complications.

Complications of an unrecognized cheek biting habit following a dental visit

Cheek biting is a chronic, usually innocuous, self-inflicted injury that is occasionally seen in children. This case report describes the characteristic features of this entity in an 8 year-old girl, including an unfortunate complication following an inferior alveolar mandibular block for restorative dental care.

[Bite wounds and infection prophylaxis. Evidence-based therapeutic recommendations]

Infections are common complications of bite wounds, changing in severity from local cellulitis to life-threatening septicaemia. Treatment recommendations are often contradictory and rarely reflect evidence-based medicine. Risk factors associated with higher rates of infection include localization on the hands, puncture wounds and age older than 50 years. The literature is critically reviewed for evidence-based treatment of bite wounds. The results are discussed with respect to common practice in Denmark.

Treating mammalian bite wounds

The incidence of dog, cat and human bites has been increasing steadily and represents an important cause of morbidity and mortality in the United States. Approximately half of all Americans will suffer a bite wound during their lifetime, and the annual medical costs of managing these injuries has been estimated to be over $100 million. Possible complications may include disfigurement, dismemberment and infection. Effective management requires rapid medical evaluation and may necessitate surgical intervention and prophylactic antibiotic therapy. As bite wounds are microbiologically diverse and most often polymicrobial in nature, selection of an appropriate antibiotic regimen requires knowledge of common pathogens. Close clinical follow-up is recommended to minimize the risk of late complications.

Metachronous multiple carcinoma of lip after surgery for gingival carcinoma: a case report

A case of multiple carcinoma of the lower lip probably induced by repeated bite trauma due to lack of sensation is reported. A reduction in immunocompetence by carboplatin (CBDCA) might be an additional condition for the carcinogenesis. This case suggests that the reconstruction of the sensory nerve is important after resection of a malignant tumor of the head and neck region.

Genital ulcer caused by human bite to the penis

BACKGROUND AND OBJECTIVES

Human bite injuries, while less frequent than cat or dog bites, usually stem from aggressive behavior, sports, or sexual activity. It has been thought that human bites have a higher rate of infection than animal bites, but this view is likely skewed because of the frequency of closed fist injuries presenting to emergency rooms. Human bites to the genitalia also occur, but are not often reported because of embarrassment.

GOAL OF THE STUDY

We report a genital ulceration after a human bite to the penis and review appropriate diagnostic and therapeutic maneuvers.

STUDY DESIGN

This article reports the development of a severe genital ulcer associated with a human bite to the penis secondarily infected, as verified by culture, with an oral flora organism Eikenella corrodens.

RESULTS

The genital ulceration healed after appropriate antibiotic therapy.

CONCLUSIONS

Treatment of human bites focuses on obtaining an accurate history and performing a salient physical examination, as well as early irrigation and debridement. Transmission of communicable disease should be considered as a possible consequence. Prophylactic antibiotic treatment and primary closure of wounds continue to be areas of controversy.

Human bites and the risk of human immunodeficiency virus transmission

The risk of human immunodeficiency virus (HIV) transmission following a bite injury is important to many groups of people. The first are those who are likely to be bitten as an occupational risk, such as police officers and institutional staff. Another group are represented by the victims and perpetrators of crimes involving biting, both in attack and defense situations. The possibility of these bites transmitting a potentially fatal disease is of interest to the physicians who treat such patients and the legal system which may have to deal with the repercussions of such a transmission. Bite injuries represent 1% of all emergency department admissions in the United States, and human bites are the third most common following those of dogs and cats. The worldwide epidemic of HIV and acquired immunodeficiency syndrome (AIDS) continues, with >5 million new cases last year and affecting 1 in 100 sexually active adults. A review of the literature concerning human bites, HIV and AIDS, HIV in saliva, and case examples was performed to examine the current opinion regarding the transmission of HIV via this route. A bite from an HIV-seropositive individual that breaks the skin or is associated with a previous injury carries a risk of infection for the bitten individual.

A human bite

We report the transmission of group A streptococci by a human bite leading to severe necrotising fasciitis. Rapid surgical and antibiotic treatment led to healing without fractional loss of the patient's infected leg.

Amputation of the penis by human bite: a case report

A 3-year-old boy had his penis amputated by being bitten by a neglected psychiatric individual and presented late with urethral stricture. Initially, he had suprapubic diversion of urine and later meatoplasty. A plea is made for vigilance with children and appropriate care of individuals with psychiatric problems.

[Clenched fist injuries from teeth: not to be disregarded]

During the delivery of a blow to the jaw, two men, 33 and 34 years of age, suffered an injury at the level of the right metacarpophalangeal joint in, respectively, the 4th and 3rd digit. In both cases, purulent arthritis and destruction of the MCP-joint developed. Clenched-fist injuries are known for their severe complications such as septic arthritis, osteomyelitis and persistent infection leading to amputation. These complications are due to the easy perforation of the MCP-joint capsule and the fact that the patients do not seek medical treatment until a significant inflammatory process has developed. Exploration of the wound on a flexed hand is crucial to exclude perforation of tendon, joint and bone. The wound should be left open to avoid infections. In case of infections, which can be caused by a variety of aerobic and anaerobic bacteria, the recommended treatment is immediate debridement and administration of broad-spectrum antibiotics.