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Schlein S, Park A, Sethi S. Animal Bites and Attacks. Emerg Med Clin North Am 2024; 42:639-652. [PMID: 38925779 DOI: 10.1016/j.emc.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
This text serves to familiarize readers with animal bites and attacks. Topics include appropriate management of animal bite wounds, postexposure prophylaxis for possible rabies exposures, and unique infectious diseases transmitted through animal vectors. Large mammal attacks are discussed, in addition to the management of smaller animal attacks and exposures.
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Affiliation(s)
- Sarah Schlein
- Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.
| | - Andrew Park
- Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA
| | - Sameer Sethi
- Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA
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Hodea FV, Grosu-Bularda A, Teodoreanu RN, Cretu A, Ratoiu VA, Lascar I, Hariga CS. Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections-A Five-Year Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:895. [PMID: 38929511 PMCID: PMC11205443 DOI: 10.3390/medicina60060895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Hand septic arthritis is a potentially debilitating condition that can significantly affect patient functionality and quality of life. Understanding the demographic, clinical, and microbiological characteristics of this condition is crucial for its effective treatment and management. This study aimed to analyze the demographic and clinical profiles of patients with hand septic arthritis, to identify common microbial pathogens, and to evaluate the impact of various factors on clinical course and treatment outcomes. Material and Methods: This cross-sectional retrospective study examined patients diagnosed with septic arthritis of the hand, focusing on their demographic data, clinical presentation, causative organisms, treatment methods, and outcomes. Data on age, sex, cause of infection, affected sites, surgical interventions, microbiological findings, and patient outcomes were also collected. Results: This study found a higher prevalence of septic arthritis in males and identified bite as the predominant cause. Staphylococcus aureus is the most common pathogen. A large number of patients did not exhibit bacterial growth, and bacterial resistance did not significantly affect the outcome. Outcomes were statistically influenced by the timing of medical presentation and the presence of comorbidities. Conclusions: Early diagnosis and intervention are critical for effective management of hand septic arthritis. This study underscores the need for a comprehensive approach that considers patient demographic and clinical characteristics to optimize treatment outcomes. Awareness and preventive measures are essential to reduce the incidence and severity of this condition.
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Affiliation(s)
- Florin-Vlad Hodea
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (F.-V.H.); (R.N.T.); (I.L.); (C.-S.H.)
- Clinic of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital Bucharest, 050474 Bucharest, Romania; (A.C.); (V.-A.R.)
| | - Andreea Grosu-Bularda
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (F.-V.H.); (R.N.T.); (I.L.); (C.-S.H.)
- Clinic of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital Bucharest, 050474 Bucharest, Romania; (A.C.); (V.-A.R.)
| | - Razvan Nicolae Teodoreanu
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (F.-V.H.); (R.N.T.); (I.L.); (C.-S.H.)
- Clinic of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital Bucharest, 050474 Bucharest, Romania; (A.C.); (V.-A.R.)
| | - Andrei Cretu
- Clinic of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital Bucharest, 050474 Bucharest, Romania; (A.C.); (V.-A.R.)
| | - Vladut-Alin Ratoiu
- Clinic of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital Bucharest, 050474 Bucharest, Romania; (A.C.); (V.-A.R.)
| | - Ioan Lascar
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (F.-V.H.); (R.N.T.); (I.L.); (C.-S.H.)
- Clinic of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital Bucharest, 050474 Bucharest, Romania; (A.C.); (V.-A.R.)
| | - Cristian-Sorin Hariga
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (F.-V.H.); (R.N.T.); (I.L.); (C.-S.H.)
- Clinic of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital Bucharest, 050474 Bucharest, Romania; (A.C.); (V.-A.R.)
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Septelici D, Carbone G, Cipri A, Esposito S. Management Strategies for Common Animal Bites in Pediatrics: A Narrative Review on the Latest Progress. Microorganisms 2024; 12:924. [PMID: 38792754 PMCID: PMC11124134 DOI: 10.3390/microorganisms12050924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/28/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
Animal bites are a common reason for children to visit primary care and emergency departments. Dog bites are the most prevalent, followed by cat bites at 20-30%. Other animals such as bats, monkeys, snakes, and rats collectively contribute less than 1% of cases. Hospitalization is necessary in only 4% of animal bite incidents. The main aim of this narrative review is to summarize the main protocols currently followed in pediatrics in cases involving the most common bites from different animal species. Analysis of the literature showed that the management of common animal bites in children presents a multifaceted challenge requiring a comprehensive understanding of the epidemiology, clinical presentation, and treatment modalities associated with each specific species. Effective wound management is paramount in reducing the risk of infection and promoting optimal healing outcomes. Additionally, tetanus vaccination status should be assessed and updated as necessary, and prophylactic antibiotics may be indicated in certain cases to prevent secondary infections. Furthermore, the role of rabies prophylaxis cannot be overstated, particularly in regions where rabies is endemic or following bites from high-risk animals. In addition to medical management, psychosocial support for both the child and their caregivers is integral to the overall care continuum. Future studies exploring the efficacy of novel treatment modalities, such as topical antimicrobial agents or advanced wound dressings, may offer new insights into optimizing wound healing and reducing the risk of complications.
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Affiliation(s)
| | | | | | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (D.S.); (G.C.); (A.C.)
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Rhodes IJ, Mwangi MW, Romeo DJ, Rhodes WR, Rohde C. Management of Human Bites in a Rural Kenyan Setting: A Plastic Surgeon's 8-Year Experience. Ann Plast Surg 2024; 92:86-91. [PMID: 37962161 DOI: 10.1097/sap.0000000000003730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
INTRODUCTION The treatment of human bites is a common issue facing healthcare practitioners in the developing countries of Sub-Saharan Africa where it has been noted as a growing public health concern. Generally, the desired outcomes from surgical management are healing, function, and aesthetics. We share our 8-year experience at Kapsowar Hospital in Kenya with the presentation, management, and outcome of human bites. We are uniquely situated to do so given the prevalence of human biting in our community and the full-time presence of a plastic surgeon at our institution. To the best of our knowledge, this study is the first to present human bite surgical management by a plastic surgeon certified by the American Board of Surgery working full-time on the African continent. METHODS A retrospective chart review was conducted on all patients who presented to the operating theater at Kapsowar Hospital with a human bite between 2013-2021. After identification of eligible patients, charts were reviewed assessing parameters including age, gender, timing from injury to presentation at hospital, localization of bite, severity of facial wounds using Lackmann's classification, surgical procedure(s), postoperative complications, surgical revisions, antibiotics administered, and circumstance of incident. Data were analyzed using SPSS 29.0.0.0. RESULTS Forty-four patients were identified. Seventeen (38.6%) were female and 27 (61.4%) were male. Thirty-one patients had facial bites and 13 patients had bites to other parts of the body. Of facial bites, 70.3% resulted in amputation of the affected part while 29.7% were lacerations. Using Lackmann's classification for facial bite severity, IIIA bites (complete avulsion) were most common for both males (9) and females (7). Females comprised 68.4% of total lip bite victims. Bites to the extremity were associated with late presentation and infection. We report a salvage rate of 85.7% for infected digits. CONCLUSIONS Compared with most other studies on human bites, our patient population presents with a higher rate of avulsive lip injuries, most commonly among women. Our postoperative infection rate is lower than many others reported in the literature. Satisfactory cosmetic outcome with low risk of infection can be achieved by following well-established principles of wound healing and tension-free closure.
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Affiliation(s)
- Isaiah J Rhodes
- From the Columbia University Vagelos College of Physicians and Surgeons, New York City, NY
| | - Mark W Mwangi
- Plastic and Reconstructive Surgery Department, Kapsowar Hospital, Kapsowar, Kenya
| | - Dominic J Romeo
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - W R Rhodes
- Plastic and Reconstructive Surgery Department, Kapsowar Hospital, Kapsowar, Kenya
| | - Christine Rohde
- From the Columbia University Vagelos College of Physicians and Surgeons, New York City, NY
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Rocha JLFDN, Leão CCA, Canedo LR, Macedo LFRD, Rosa SC, Macedo JLSD. Epidemiological Profile of Victim Patients of Facial Canine and Human Bites in a Public Hospital. J Craniofac Surg 2023:00001665-990000000-01181. [PMID: 37948634 DOI: 10.1097/scs.0000000000009818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/26/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Bites are among the most common types of trauma to which humans are exposed. The possibility of disfiguring lesions and the transmission of infectious diseases with high morbidity make this trauma a public health problem. METHOD This was a retrospective, descriptive study that analyzed the medical records of patients treated at the Emergency Unit of the Plastic Surgery Service of the Asa Norte Regional Hospital from March 2019 to March 2020. The variables analyzed included age, sex, origin, time interval from aggression to hospital care, aggressor agent, wound site, lesion characteristics, and treatment. RESULTS A total of 103 patients with a mean age of 25 years were evaluated. Most patients were male (57.3%), and 73.8% were from the Federal District. The most common type of treatment was direct suturing in 77.7% of cases, followed by local flaps (15.5%) or grafts (4.9%). There were no deaths or infections reported. CONCLUSION The predominant profile of a facial bite victim is a young male adult living in the Federal District, bitten by a canine and treated with direct sutures. Adequate treatment for animal bites should include prevention of infection, such as rabies and tetanus, as well as primary wound closure for achieving a better prognosis and satisfactory esthetics for the patient.
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Affiliation(s)
| | | | - Lucas Ribeiro Canedo
- Asa Norte Regional Hospital, Plastic Surgery Service
- Graduate Program in Health Sciences, Foundation for Teaching and Research in Health Sciences
| | | | - Simone Corrêa Rosa
- Asa Norte Regional Hospital, Plastic Surgery Service
- Medical School of the Catholic University of Brasília, Brasília, DF, Brazil
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Maurer M, Schlipköter C, Gottsauner M, Waiss W, Meier JK, Fiedler M, Schuderer JG, Taxis J, Reichert TE, Ettl T. Animal Bite Injuries to the Face: A Retrospective Evaluation of 111 Cases. J Clin Med 2023; 12:6942. [PMID: 37959407 PMCID: PMC10649818 DOI: 10.3390/jcm12216942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/15/2023] Open
Abstract
The treatment of bite wounds to the face is discussed controversially in relation to surgery and antibiotics. The aim of this study is a retrospective evaluation of 111 cases of animal bite injuries to the face that presented to our unit of oral and maxillofacial surgery over a 13-year period. Children under 10 years of age were predominantly involved. A total of 94.5% of the assessed injuries were caused by dogs. Wound infections occurred in 8.1%. Lackmann type II was the most common type of injury (36.9%). The perioral area was affected most frequently (40.5%). Primary wound closure was carried out in 74.8% of the cases. In 91.9% of the cases, antibiotic prophylaxis was prescribed. The most often administered type of antibiotic was amoxicillin with clavulanic acid (62.1%). Patients without antibiotics showed an increased infection rate without significance. Wound infections occurred significantly more frequently in wounds to the cheeks (p = 0.003) and when local flap reconstruction was necessary (p = 0.048). Compared to the other surgical treatment options, primary closure showed the lowest infection rates (4.8%, p = 0.029). We recommend antibiotic prophylaxis using amoxicillin with clavulanic acid and wound drains for wounds of Lackmann class II or higher. Primary closure seems to be the treatment of choice whenever possible.
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Affiliation(s)
- Michael Maurer
- Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
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Trauma Surgery. J Oral Maxillofac Surg 2023; 81:E147-E194. [PMID: 37833022 DOI: 10.1016/j.joms.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Yi L, Zhu S, Wu P, Zhang Y, Wang M, Xu P, Zeng J, Wang G, Luo L, Li W. Catalysis-Mediated Male Contraception through Black Phosphorus Nanosheets. ACS APPLIED MATERIALS & INTERFACES 2023; 15:42284-42292. [PMID: 37646168 DOI: 10.1021/acsami.3c09574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Nanocontraception has been proposed and received extensive attention in recent years for population control. However, currently developed methods for nanocontraception still face problems in efficacy and safety. Here, we propose catalysis-mediated oxidation as a new strategy for nanocontraception. With the catalytic production of highly oxidative species, male contraception was successfully achieved after the administration of black phosphorus nanosheets into the testes of male mice. Further mechanistic studies revealed that contraception was induced by oxidative stress and apoptosis of spermatogenesis cells. Meanwhile, the apoptosis of germ cells released testis antigen and induced immune cell infiltration, which enhanced reproductive damage. Notably, the introduced black phosphorus nanosheets naturally degraded during the catalytic oxidation process and ultimately converted to harmless phosphates, indicating the safety of the strategy. Furthermore, the catalysis-mediated strategy avoids utilizing additional inducers, such as near-infrared irradiation, magnetic fields, or ultrasound, which may cause severe pain. In summary, the proposed catalysis-mediated contraception can be a self-cleared, convenient, and safe strategy for controlling male fertility.
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Affiliation(s)
- Lirong Yi
- Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong, Jiangsu 226019, P. R. China
| | - Shiyao Zhu
- Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong, Jiangsu 226019, P. R. China
| | - Pengfei Wu
- Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong, Jiangsu 226019, P. R. China
| | - Yuhang Zhang
- Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong, Jiangsu 226019, P. R. China
| | - Mo Wang
- Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong, Jiangsu 226019, P. R. China
| | - Pengping Xu
- Hefei National Research Center for Physical Sciences at the Microscale, Key Laboratory of Strongly-Coupled Quantum Matter Physics of Chinese Academy of Sciences, Key Laboratory of Surface and Interface Chemistry and Energy Catalysis of Anhui Higher Education Institutes, Department of Chemical Physics, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Jie Zeng
- Hefei National Research Center for Physical Sciences at the Microscale, Key Laboratory of Strongly-Coupled Quantum Matter Physics of Chinese Academy of Sciences, Key Laboratory of Surface and Interface Chemistry and Energy Catalysis of Anhui Higher Education Institutes, Department of Chemical Physics, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Guishuan Wang
- Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong, Jiangsu 226019, P. R. China
| | - Laihao Luo
- Hefei National Research Center for Physical Sciences at the Microscale, Key Laboratory of Strongly-Coupled Quantum Matter Physics of Chinese Academy of Sciences, Key Laboratory of Surface and Interface Chemistry and Energy Catalysis of Anhui Higher Education Institutes, Department of Chemical Physics, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Wenqing Li
- Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong, Jiangsu 226019, P. R. China
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Rojas CA, Entrolezo Z, Jarett JK, Jospin G, Kingsbury DD, Martin A, Eisen JA, Ganz HH. Microbiome Responses to Fecal Microbiota Transplantation in Cats with Chronic Digestive Issues. Vet Sci 2023; 10:561. [PMID: 37756083 PMCID: PMC10537086 DOI: 10.3390/vetsci10090561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/25/2023] [Accepted: 09/02/2023] [Indexed: 09/28/2023] Open
Abstract
There is growing interest in the application of fecal microbiota transplants (FMTs) in small animal medicine, but there are few published studies that have tested their effects in the domestic cat (Felis catus). Here we use 16S rRNA gene sequencing to examine fecal microbiome changes in 46 domestic cats with chronic digestive issues that received FMTs using lyophilized stool that was delivered in oral capsules. Fecal samples were collected from FMT recipients before and two weeks after the end of the full course of 50 capsules, as well as from their stool donors (N = 10), and other healthy cats (N = 113). The fecal microbiomes of FMT recipients varied with host clinical signs and dry kibble consumption, and shifts in the relative abundances of Clostridium, Collinsella, Megamonas, Desulfovibrio and Escherichia were observed after FMT. Overall, donors shared 13% of their bacterial amplicon sequence variants (ASVs) with FMT recipients and the most commonly shared ASVs were classified as Prevotella 9, Peptoclostridium, Bacteroides, and Collinsella. Lastly, the fecal microbiomes of cats with diarrhea became more similar to the microbiomes of age-matched and diet-matched healthy cats compared to cats with constipation. Overall, our results suggest that microbiome responses to FMT may be modulated by the FMT recipient's initial presenting clinical signs, diet, and their donor's microbiome.
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Affiliation(s)
- Connie A. Rojas
- Genome Center, University of California, Davis, CA 95616, USA; (C.A.R.); (J.A.E.)
- Department of Evolution and Ecology, University of California, Davis, CA 95616, USA
| | - Zhandra Entrolezo
- AnimalBiome, Oakland, CA 94609, USA; (Z.E.); (J.K.J.); (G.J.); (A.M.)
| | - Jessica K. Jarett
- AnimalBiome, Oakland, CA 94609, USA; (Z.E.); (J.K.J.); (G.J.); (A.M.)
| | - Guillaume Jospin
- AnimalBiome, Oakland, CA 94609, USA; (Z.E.); (J.K.J.); (G.J.); (A.M.)
| | - Dawn D. Kingsbury
- AnimalBiome, Oakland, CA 94609, USA; (Z.E.); (J.K.J.); (G.J.); (A.M.)
| | - Alex Martin
- AnimalBiome, Oakland, CA 94609, USA; (Z.E.); (J.K.J.); (G.J.); (A.M.)
| | - Jonathan A. Eisen
- Genome Center, University of California, Davis, CA 95616, USA; (C.A.R.); (J.A.E.)
- Department of Evolution and Ecology, University of California, Davis, CA 95616, USA
| | - Holly H. Ganz
- AnimalBiome, Oakland, CA 94609, USA; (Z.E.); (J.K.J.); (G.J.); (A.M.)
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Masum MHU, Rajia S, Bristi UP, Akter MS, Amin MR, Shishir TA, Ferdous J, Ahmed F, Rahaman MM, Saha O. In Silico Functional Characterization of a Hypothetical Protein From Pasteurella Multocida Reveals a Novel S-Adenosylmethionine-Dependent Methyltransferase Activity. Bioinform Biol Insights 2023; 17:11779322231184024. [PMID: 37424709 PMCID: PMC10328030 DOI: 10.1177/11779322231184024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Genomes may now be sequenced in a matter of weeks, leading to an influx of "hypothetical" proteins (HP) whose activities remain a mystery in GenBank. The information included inside these genes has quickly grown in prominence. Thus, we selected to look closely at the structure and function of an HP (AFF25514.1; 246 residues) from Pasteurella multocida (PM) subsp. multocida str. HN06. Possible insights into bacterial adaptation to new environments and metabolic changes might be gained by studying the functions of this protein. The PM HN06 2293 gene encodes an alkaline cytoplasmic protein with a molecular weight of 28352.60 Da, an isoelectric point (pI) of 9.18, and an overall average hydropathicity of around -0.565. One of its functional domains, tRNA (adenine (37)-N6)-methyltransferase TrmO, is a S-adenosylmethionine (SAM)-dependent methyltransferase (MTase), suggesting that it belongs to the Class VIII SAM-dependent MTase family. The tertiary structures represented by HHpred and I-TASSER models were found to be flawless. We predicted the model's active site using the Computed Atlas of Surface Topography of Proteins (CASTp) and FTSite servers, and then displayed it in 3 dimensional (3D) using PyMOL and BIOVIA Discovery Studio. Based on molecular docking (MD) results, we know that HP interacts with SAM and S-adenosylhomocysteine (SAH), 2 crucial metabolites in the tRNA methylation process, with binding affinities of 7.4 and 7.5 kcal/mol, respectively. Molecular dynamic simulations (MDS) of the docked complex, which included only modest structural adjustments, corroborated the strong binding affinity of SAM and SAH to the HP. Evidence for HP's possible role as an SAM-dependent MTase was therefore given by the findings of Multiple sequence alignment (MSA), MD, and molecular dynamic modeling. These in silico data suggest that the investigated HP might be used as a useful adjunct in the investigation of Pasteurella infections and the development of drugs to treat zoonotic pasteurellosis.
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Affiliation(s)
- Md. Habib Ullah Masum
- Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Sultana Rajia
- Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Uditi Paul Bristi
- Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Mir Salma Akter
- Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Mohammad Ruhul Amin
- Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Tushar Ahmed Shishir
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Jannatul Ferdous
- Department of Medicine, Abdul Malek Ukil Medical College, Noakhali, Bangladesh
| | - Firoz Ahmed
- Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | | | - Otun Saha
- Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
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Ehrhard S, Keller M, Morgenstern L, Müller M, Ricklin ME, Klukowska-Rötzler J, Exadaktylos AK, Jakob DA. Presentation and treatment of animal and human bite injuries at a Swiss tertiary emergency department: a cross-sectional study. Swiss Med Wkly 2023; 153:40093. [PMID: 37410948 DOI: 10.57187/smw.2023.40093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Animal and human bite injuries are a relevant health problem worldwide. With the increasing number of pets, bite injuries are becoming more frequent. Previous studies on animal and human bite injuries in Switzerland were completed several years ago. The aim of the present study was to provide a detailed overview of patients with bite injuries admitted to a tertiary emergency department in Switzerland in terms of demographics, injury patterns and treatment strategies. METHODS A 9-year cross-sectional analysis of patients presenting to the emergency department of Bern University Hospital in the period January 2013 to December 2021 following an animal or human bite injury. RESULTS A total of 829 patients with bite injuries were identified, including 70 for postexposure prophylaxis only. Their median age was 39 (IQR 27-54) years and 53.6% were female. Most patients were bitten by a dog (44.3%), followed by cats (31.5%) and humans (15.2%). Most bite injuries were mild (80.2%); severe injuries were mainly found in dog bites (28.3%). Most patients were treated within six hours after human (80.9%) or dog (61.6%) bites; after cat bites, patients often presented with a delay (74.5%) and signs of infection (73.6%). Human bite wounds were superficial in the majority of cases (95.7%), rarely showed signs of infection (5.2%) at the time of presentation and hospitalisation was never required. CONCLUSIONS Our study provides a detailed overview of patients admitted to an emergency department of a tertiary Swiss University Hospital after an animal or human bite. In summary, bite injuries are common among patients who present to the emergency department. Therefore, primary and emergency care clinicians should be familiar with these injuries and their treatment strategies. The high risk of infection, particularly in cat bites, may warrant surgical debridement in the initial treatment of these patients. Prophylactic antibiotic therapy and close follow-up examinations are recommended in most cases.
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Affiliation(s)
- Simone Ehrhard
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Mirjam Keller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Linda Morgenstern
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Meret E Ricklin
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Jolanta Klukowska-Rötzler
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Aristomenis K Exadaktylos
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Dominik A Jakob
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Schär L, Haug L, Vögelin E, Meierb R. Bite injuries to the hand and forearm: analysis of hospital stay, treatment and costs. J Hand Surg Eur Vol 2023; 48:41-45. [PMID: 36205065 DOI: 10.1177/17531934221129995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We retrospectively reviewed the charts of patients treated for bite injuries in our clinic from 2014 to 2019. The time from the bite event to surgery, duration of hospital stay, duration of antibiotic treatment, complications, incapacity for work and costs were analysed. Cat bites were compared with the other bite injuries and were found to be more problematic. The results of early (within 24 hours) and delayed treatment in cat bite injuries were compared. Treated early they were associated with a shorter hospital stay (1.4 versus 2.4 days), shorter duration of antibiotic treatment (9.7 versus 12.6 days), lower complication rate (10% versus 18%), lower cost (CHF4606 versus 8072) (£4061 versus £7116; US$4771 versus US$8361; €4788 versus €8390) and a shorter incapacity for work (15 versus 43 days). Surgical treatment must be carried out as early as possible. The public and physicians require education to reduce the frequency of these injuries and the associated costs.Level of evidence: IV.
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Affiliation(s)
- Lukas Schär
- Department of General Surgery, Spitalzentrum Centre hospitalier Biel-Bienne, Switzerland
| | - Luzian Haug
- Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Berner Handzentrum, Bern, Switzerland
| | - Esther Vögelin
- Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Rahel Meierb
- Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Berner Handzentrum, Bern, Switzerland
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13
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Outcome of human amniotic membrane wrap around neurorrhaphy in high radial nerve injury - a case report following monkey bite. Injury 2022; 53:3858-3861. [PMID: 35249738 DOI: 10.1016/j.injury.2022.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Peripheral nerve injury due to animal bite is a rare phenomenon. Most animal bites are from dogs. Monkey bites constitute a common risk, second only to dog bites, among travelers. Peripheral nerve injuries may occur due to a combination of monkey's strong jaws and sharp long teeth penetrating deep into the soft tissues. Such injuries are associated with increased perineural fibrosis. Human amniotic membrane (HAM) wrap around the nerve repair site reduces fibrotic response, prevents adhesions and scar formation thereby improving outcome. We report a case of "High Radial nerve palsy due to monkey bite, treated by neurorrhaphy with HAM wrap". METHOD A 3-year old boy presented with wrist drop, and inability to extend the fingers and thumb of his right dominant hand, following a monkey bite over the distal arm. The diagnosis of high radial nerve injury was corroborated by high frequency ultrasound and electrodiagnostic studies. On exploration the radial nerve was found to be transected. An end to end repair was performed, with HAM wrap around the neurorrhaphy. RESULTS Wrist dorsiflexion recovered at 2.5 months followed by active finger and thumb extension at 4 months with no infection or immune rejection. CONCLUSION Nerve regeneration in our patient occurred at a faster rate as compared to the conventional 1 mm/day. This could be attributed to decreased perineural fibrosis, improved neurotropism due to the HAM wrap and neuronal plasticity in young brain in addition, the patient being a small child having better regenerative ability in comparison to an adult.
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14
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Dog bite injuries to the face: A narrative review of the literature. World J Otorhinolaryngol Head Neck Surg 2022; 8:239-244. [PMID: 36159909 PMCID: PMC9479474 DOI: 10.1016/j.wjorl.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/01/2020] [Indexed: 11/24/2022] Open
Abstract
Objective Dog bite injuries remain a public health concern for two key reasons: the physical threat to health following attack and the infective sequelae a canine bite can incur. Facial bite injuries can result in significant emotional, psychological and physical trauma to victims involved. This narrative review elucidates the current presentation and management of dog bite injuries to the face. Data Sources and Methods A literature search was conducted electronically using the search terms “dog bite” and “face” and “management” using the National Library of Medicine (Pubmed) and the Cochrane Library. There were no time nor language restrictions. A total of 79 studies were initially retrieved using the search algorithm. After screening of the titles and abstracts, 9 full texts were retrieved, and a total of 7 studies included. Results The number of patients included in each study following a dog bite ranged from 40 to 223. The percentage of children included in each study (aged <18 years old) ranged from 27.5% to 100%. The majority of dog bite injuries to the face were managed by primary repair, ranging from 56.3% to 100%. Prophylactic antibiotics were used in most studies for dog bite injuries, ranging from 81% to 100%. The secondary infection rate following a dog bite ranged from 0 to 35%. Conclusion This review highlights that children are disproportionately affected by canine bite injuries to the face relative to adults. The dog involved in the attack is typically known to the victim, with the lips, the cheek and the nose representing the most common sites of facial injury. More units are managing such injuries with primary repair and prophylactic antibiotics. Reconstructive procedures most commonly involve a local or advancement flap, a full thickness skin graft or a split skin graft. These are typically performed by Plastic Surgery and Maxillofacial Surgery specialists.
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15
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Hino C, Veltman J. Capnocytophaga tricuspid valve endocarditis: a case report and literature review. Access Microbiol 2022; 4:acmi000355. [PMID: 36003363 PMCID: PMC9394530 DOI: 10.1099/acmi.0.000355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Abstract
Capnocytophaga canimorsus
is a Gram-negative zoonotic pathogen capable of causing serious infection following dog or cat bite. Infections often manifest as sepsis, fatal septic shock, gangrene, bacteraemia, meningitis and endocarditis. Here we report a case of
C. canimorsus
bacteraemia complicated by tricuspid valve infective endocarditis and septic pulmonary emboli.
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Affiliation(s)
- Christopher Hino
- Department of Internal Medicine, Department of Medicine, Loma Linda University, Loma Linda, California, USA
- *Correspondence: Christopher Hino,
| | - Jennifer Veltman
- Division of Infectious Disease, Department of Medicine, Loma Linda University, Loma Linda, California, USA
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16
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Abdul Aziz AM, Ismail AS, Yaakub A. Ocular Cat Bite Injury: A Case Report and Literature Review. Cureus 2022; 14:e24636. [PMID: 35663645 PMCID: PMC9152695 DOI: 10.7759/cureus.24636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/07/2022] Open
Abstract
Ocular injury related to cat bites is rare, and no proper guidelines have been suggested for the treatment of such injuries. We report a rare case of zone II penetrating ocular injury secondary to a cat bite. A 49-year-old lady presented with left eye pain following a cat bite over the left eye, which occurred four hours prior to the presentation. Immediate primary closure with intravitreal antibiotic injections was given. Systemic and topical antibiotic treatments were administered. Presenting visual acuity was hand motion, which improved to 20/20 at six months follow-up. Throughout this period, there were no signs of endophthalmitis. Prompt and effective antibiotic administration with early surgical intervention contributed to a good visual prognosis in this case.
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17
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Stanbouly D, Stewart SJ, Harris JA, Chuang SK. Risk factors associated with infection in patients sustaining dog bites to the face. Oral Maxillofac Surg 2022:10.1007/s10006-022-01066-x. [PMID: 35488948 DOI: 10.1007/s10006-022-01066-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/23/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to identify which patient-level factors, if any, influence the risk of infection following dog bite wounds to the face. MATERIALS AND METHODS This retrospective cohort study was conducted using the Kids' Inpatient Database (KID). The primary predictor variable was the type of facial injury. The primary outcome variable was the presence of facial infection. SPSS was used to perform statistical analyses and statistical significance was set at a P-value of < 0.05. RESULTS Our final sample comprised a total of 4,420 patients who suffered dog bites to the face, of which 1,237 (28.0%) resulted in infection. Open wound (n = 4,176, 94.5%) was the most common facial injury, followed by bone fractures (n = 105, 2.4%). Relative to children 16-20 years old, children who were 0-5 years old were three times more likely to develop an infection (P < 0.01). Finally, open wounds (P < 0.01) were over seven times more likely to get infected relative to fractures. CONCLUSIONS Young children, particularly those below the age of five, are vulnerable to dog bite wounds to the face. Open wounds posed the greatest risk of getting infected.
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Affiliation(s)
- Dani Stanbouly
- Columbia University College of Dental Medicine, New York, NY, USA
| | - Sara J Stewart
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jack A Harris
- Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA.
| | - Sung-Kiang Chuang
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Brockton Oral and Maxillofacial Surgery Inc, Brockton, USA.,Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, MA, USA.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
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18
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Boettler MA, Kaffenberger BH, Chung CG. Cellulitis: A Review of Current Practice Guidelines and Differentiation from Pseudocellulitis. Am J Clin Dermatol 2022; 23:153-165. [PMID: 34902109 DOI: 10.1007/s40257-021-00659-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
Cellulitis, an infection involving the deep dermis and subcutaneous tissue, is the most common reason for skin-related hospitalization and is seen by clinicians across various disciplines in the inpatient, outpatient, and emergency room settings, but it can present as a diagnostic and therapeutic challenge. Cellulitis is a clinical diagnosis based on the history of present illness and physical examination and lacks a gold standard for diagnosis. Clinical presentation with acute onset of redness, warmth, swelling, and tenderness and pain is typical. However, cellulitis can be difficult to diagnose due to a number of infectious and non-infectious clinical mimickers such as venous stasis dermatitis, contact dermatitis, eczema, lymphedema, and erythema migrans. Microbiological diagnosis is often unobtainable due to poor sensitivity of culture specimens. The majority of non-purulent, uncomplicated cases of cellulitis are caused by β-hemolytic streptococci or methicillin-sensitive Staphylococcus aureus, and appropriate targeted coverage of this pathogen with oral antibiotics such as penicillin, amoxicillin, and cephalexin is sufficient. Even with rising rates of community-acquired methicillin-resistant Staphylococcus aureus, coverage for non-purulent cellulitis is generally not recommended.
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19
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Żyluk A. Bite wounds to the hand - a review. POLISH JOURNAL OF SURGERY 2022; 94:54-59. [PMID: 36169586 DOI: 10.5604/01.3001.0015.7673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Bite wounds occur as a result of bite by an animal or a human. They are relatively frequent due to the growing number of pets living with people, as well as from inadequate human-animal interactions. The knowledge of most surgeons about the management of these injuries is relatively outdated, whereas the current literature points to important changes in this field. The article presents several aspects concerning epidemiology, classification, bacteriology, and characteristics of bite wounds to the hand. Based on the actual literature, detailed rules for the management of these injuries are described. This information may prove useful in the daily practice of surgeons and doctors at emergency departments who are frequently faced with bite wounds.
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Affiliation(s)
- Andrzej Żyluk
- Department of General and Hand Surgery, Pomeranian Medical University in Szczecin, Poland
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20
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Vardanega J, Smith LK, Smith S, Hanson J. Animal bite wounds and their management in tropical Australia. Int J Infect Dis 2022; 118:1-9. [DOI: 10.1016/j.ijid.2022.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/24/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022] Open
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21
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Bites and Stings. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Patel SR, Kanabur P, Possoit HE, Kinley A, Beatriz V, Coburn M, Sukumar S. Management of Mammalian Bites to the External Genitalia: A Scoping Review. BJU Int 2021; 130:722-729. [PMID: 34897940 DOI: 10.1111/bju.15671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/04/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review the existing publications in literature in order to determine the approaches for the medical and operative management of mammalian bites to the external genitalia. METHODS AND MATERIAL The Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Review guidelines were followed. Four databases were searched. Articles were independently screened and analyzed by two reviewers. Publications were included if detailed summaries of genitalia bites and management were documented. Discrepancies were resolved by a third reviewer. Data was extracted from the final article cohort. RESULTS Forty-two articles were included in this scoping review. A total of 67 cases of mammalian bites to the genitalia were reported in the cohort. The most common injury site was the penis (44.9%). Dog and human bites were the most common type of mammalian bites (61.2% and 26.9%, respectively). 13.4% of cases were managed with medical therapy while 86.6% of cases required surgical intervention. The most common intervention was wound irrigation, debridement, and primary closure (32.8%). Though uncommon, other operative approaches included skin flaps (7.5%) and grafts (4.5%), re-implantation (4.5%), urethroplasty/repair (7.5%), penectomy (3.0%), scrotoplasty (3.0%), and perineal urethrostomy (1.5%). The reported complication rate was 19.4%. The mean follow-up time was 39.9 months. CONCLUSION Trauma related to mammalian bites is associated with high utilization of healthcare resources and cost. Though management of such bites to the genitalia is controversial, surgical intervention is often warranted ranging from simple debridement of devitalized tissue to complex reconstructive surgery. This review underscores the need for further investigation of mammalian bites to the genitalia to improve surgical options and monitor for long-term complication rates.
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Affiliation(s)
- Sagar R Patel
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
| | - Pratik Kanabur
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
| | - Harlee E Possoit
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Louisiana State University Health Shreveport, School of Medicine, Shreveport, Louisiana, USA
| | - Austin Kinley
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Michael Coburn
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
| | - Shyam Sukumar
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
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23
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Borkar D, Avendano P. Cat Inflicted Eye Injury in a Child. J Med Cases 2021; 12:209-212. [PMID: 34434459 PMCID: PMC8383528 DOI: 10.14740/jmc3663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/09/2021] [Indexed: 11/11/2022] Open
Abstract
Ocular injuries, especially corneal abrasions are a common phenomenon noted in the pediatric emergency department. Most of these are minor injuries and are well described in literature. However, there is very limited data on corneal cat scratch injuries and their management. We present the case of a 10-year-old female with cat scratch inflicted superficial corneal laceration. In addition to immediate identification of the injury, it is essential to investigate and evaluate the depth of the ocular injury for prompt management, including route of antibiotics, need for an immediate surgical intervention and future follow-up.
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Affiliation(s)
- Deeksha Borkar
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Pablo Avendano
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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24
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Williams BM, Purcell L, Kayange L, Gallaher J, Charles A. Characteristic and outcomes of human and animal bites in Malawi. Injury 2021; 52:2188-2193. [PMID: 33785190 PMCID: PMC8380653 DOI: 10.1016/j.injury.2021.03.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Bites are an important contributor to traumatic injury worldwide. In low- and middle-income countries, data regarding bite injuries outside of rabies is limited. Therefore, we sought to describe the injury characteristics and outcomes of bites in Lilongwe, Malawi, and determine risk factors for animals and human bites. METHODS We performed a retrospective analysis of the Kamuzu Central Hospital trauma registry from 2008-2018. We performed Bivariate analyses comparing bite to non-bite trauma and human to animal bites. Multivariable Poisson regression modeling then estimated risk factors for bites. RESULTS A total of 124,394 patients were captured by the registry, of which 3,680 (3%) had a bite injury mechanism. Human bites accounted for 14.5% of bite injuries, and animals represented the remaining 85.5%. In rare cases, animal bite victims had serious complications, such as amputation (n = 6, 0.2%), orthopedic procedures (n = 5, 0.2%), and death (n = 7, 0.2%). Risk factors for an animal bite included being on a farm, field, or lake and being at home, whereas risk factors for a human bite included alcohol use and being at home. CONCLUSION Animal bite injuries in Malawi can confer a risk of serious complications, such as amputation and, in rare cases, death. Alcohol-associated, in-home interpersonal violence is a significant risk factor for human bite injuries. Further studies are needed to identify risk factors for complications and mortality.
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Affiliation(s)
- Brittney M Williams
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Laura Purcell
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Linda Kayange
- Department of Surgery, Kamuzu Central Hospital, Lilongwe Malawi
| | - Jared Gallaher
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Anthony Charles
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA; Department of Surgery, Kamuzu Central Hospital, Lilongwe Malawi.
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25
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Morgan RN, Saleh SE, Farrag HA, Aboulwafa MM. Bacterial cyclomodulins: types and roles in carcinogenesis. Crit Rev Microbiol 2021; 48:42-66. [PMID: 34265231 DOI: 10.1080/1040841x.2021.1944052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Various studies confirmed that bacterial infections contribute to carcinogenesis through the excessive accumulation of reactive oxygen species (ROS) and the expression of toxins that disrupt the cell cycle phases, cellular regulatory mechanisms and stimulate the production of tumorigenic inflammatory mediators. These toxins mimic carcinogens which act upon key cellular targets and result in mutations and genotoxicities. The cyclomodulins are bacterial toxins that incur cell cycle modulating effects rendering the expressing bacterial species of high carcinogenic potentiality. They are either cellular proliferating or cell cycle arrest cyclomodulins. Notably, cyclomodulins expressing bacterial species have been linked to different human carcinomas. For instance, Escherichia coli species producing the colibactin were highly prevalent among colorectal carcinoma patients, CagA+ Helicobacter pylori species were associated with MALT lymphomas and gastric carcinomas and Salmonella species producing CdtB were linked to hepatobiliary carcinomas. These species stimulated the overgrowth of pre-existing carcinomas and induced hyperplasia in in vivo animal models suggesting a role for the cyclomodulins in carcinogenesis. Wherefore, the prevalence and mode of action of these toxins were the focus of many researchers and studies. This review discusses different types of bacterial cyclomodulins highlighting their mode of action and possible role in carcinogenesis.
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Affiliation(s)
- Radwa N Morgan
- Drug radiation research Department, Egyptian Atomic Energy Authority (EAEA), National Center for Radiation Research and Technology (NCRRT), Cairo, Egypt
| | - Sarra E Saleh
- Faculty of Pharmacy, Microbiology and Immunology Department, Ain Shams University, Cairo, Egypt
| | - Hala A Farrag
- Drug radiation research Department, Egyptian Atomic Energy Authority (EAEA), National Center for Radiation Research and Technology (NCRRT), Cairo, Egypt
| | - Mohammad M Aboulwafa
- Faculty of Pharmacy, Microbiology and Immunology Department, Ain Shams University, Cairo, Egypt.,Faculty of Pharmacy, King Salman International University, Ras-Sedr, Egypt
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26
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Patel H, Patel N, Patel H, Chow RD. A bite difficult to heal: Pasteurella multocida induced decompensated hepatic cirrhosis. J Community Hosp Intern Med Perspect 2021; 11:379-383. [PMID: 34234911 PMCID: PMC8118415 DOI: 10.1080/20009666.2021.1906490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Pasteurella multocida is a gram-negative bacterium that colonizes domestic animals. It is commonly implicated in bite and scratch wounds, potentially resulting in cellulitis, superficial abscesses, osteomyelitis, or peritonitis. Rarely, it can lead to bacteremia and septic shock in high-risk patients. We present an atypical presentation of Pasteurella multocida bacteremia and sepsis in a patient with stage 4 decompensated cirrhosis. The patient presented with melena and altered mental status with CT imaging showing a heterogeneous nodular liver along with an enlarged portal vein, gastric varices, and ascites consistent with decompensated cirrhosis. The patient was initially managed with intravenous (IV) octreotide and pantoprazole, blood and platelet transfusions, and broad-spectrum antibiotics. Upper endoscopy showed diffuse non-bleeding esophageal and gastric varices, which required band ligation and continued IV octreotide therapy. The infection resolved after a 7-day course of IV ceftriaxone.
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Affiliation(s)
- Hiren Patel
- Department of Medicine, American University of Antigua College of Medicine, Coolidge, Antigua.,University of Maryland Medical Center Midtown Campus, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nirali Patel
- Department of Medicine, American University of Antigua College of Medicine, Coolidge, Antigua
| | - Harsh Patel
- University of Maryland Medical Center Midtown Campus, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Robert Dobbin Chow
- University of Maryland Medical Center Midtown Campus, University of Maryland School of Medicine, Baltimore, MD, USA
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27
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Abstract
Cellulitis is a common skin infection resulting in increasing hospitalizations and health care costs. There is no gold standard diagnostic test, making cellulitis a potentially challenging condition to distinguish from other mimickers. Physical examination typically demonstrates poorly demarcated unilateral erythema with warmth and tenderness. Thorough history and clinical examination can narrow the differential diagnosis of cellulitis and minimize unnecessary hospitalization. Antibiotic selection is determined by patient history and risk factors, severity of clinical presentation, and the most likely microbial culprit.
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Affiliation(s)
- Renajd Rrapi
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, 2nd Floor, Boston, MA 02114, USA
| | - Sidharth Chand
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, 2nd Floor, Boston, MA 02114, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, 2nd Floor, Boston, MA 02114, USA.
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28
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Thongtha A, Modnak C. A mathematical modeling of rabies with vaccination and culling. INT J BIOMATH 2021. [DOI: 10.1142/s179352452150039x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Rabies is a fatal contagious disease but preventable. It is a major public health problem in developing countries. Most of the rabies deaths around the world are caused by dog bites. If a person does not receive appropriate treatment after being exploded to rabies, the virus can damage the brain resulting in death. Since most of the deaths due to the transmission from dogs to humans, therefore, in this study, we will formulate a mathematical model that describes the dynamics of rabies virus transmission between dogs and humans. Also, we conduct both epidemic and endemic analysis. Optimal control theory is applied to seek cost-effective solutions for time-dependent vaccination and culling strategies against rabies outbreaks. Our results show that using vaccination during rabies outbreaks at the very beginning of the onset and culling infected dogs can reduce the number of infections significantly.
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Affiliation(s)
- Adison Thongtha
- Department of Mathematics, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Chairat Modnak
- Department of Mathematics, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
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29
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Yang MC, Ling J, Mosaed S. Capnocytophaga canimorsus blebitis: case report and review of literature. BMC Ophthalmol 2021; 21:59. [PMID: 33499831 PMCID: PMC7839216 DOI: 10.1186/s12886-021-01823-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background Capnocytophaga canimorsus is a facultative anaerobic, slow-growing, capnophilic, Gram-negative bacillus, that is commonly found in the microflora of canine and feline oral cavities. Capnocytophaga infections are an emerging zoonotic disease that can cause fatal systemic infections in immunocompromised individuals. Localized ocular Capnocytophaga infections, including keratitis, blepharitis, and endophthalmitis, can lead to severe eye threatening situations. To our knowledge, there is currently no documented case of Capnocytophaga canimorsus blebitis with bleb perforation after trabeculectomy. Case presentation Our case report and literature review features a novel case of Capnocytophaga blebitis that occurred after trabeculectomy, associated with close dog contact (i.e. face licking). The patient had underwent trabeculectomy 10 years prior and presented with conjunctival injection, perforated bleb, and hypotony. Overall, patient was medically treated subconjunctival vancomycin, gentamicin and moxifloxacin drops. Trabeculectomy revision was performed with good visual outcome. Bacterial cultures grew Capnocytophaga canimorsus. Conclusions We discuss the strategies for diagnosis, treatment, and common risk factors for ocular Capnocytophaga infections. At-risk patients with ocular infections should be asked about close contact with dogs and cats; and treated promptly with the proper antibiotic regimen.
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Affiliation(s)
- Michael C Yang
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 92697, USA
| | - John Ling
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 92697, USA
| | - Sameh Mosaed
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 92697, USA.
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Stephenson T, Lee K, Griffith JE, McLelland DJ, Wilkes A, Bird PS, Trott DJ, Speight KN, Hemmatzadeh F, Woolford L. Pulmonary Actinomycosis in South Australian Koalas ( Phascolarctos cinereus). Vet Pathol 2021; 58:416-422. [PMID: 33461422 DOI: 10.1177/0300985820973459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pneumonia has been reported in both free-ranging and captive koalas and a number of causative agents have been described. Between 2016 and 2019, 16 free-ranging and 1 captive koala (Phascolarctos cinereus) from the Mount Lofty Ranges of South Australia were identified with pyogranulomatous lobar pneumonia, which involved the left caudal lobe in 14/17 (82%) cases. Within lesions, numerous gram-positive or gram-variable, non-acid-fast filamentous bacteria were observed in association with Splendore-Hoeppli phenomenon. Culture yielded growth of anaerobic bacteria, which were unidentifiable by MALDI-TOF-MS (matrix-assisted laser desorption ionization-time of flight mass spectrometry) analysis in 5/5 cases. Sequencing of the bacterial 16S rRNA gene identified a novel Actinomyces species in 4 samples, confirming a diagnosis of pulmonary actinomycosis. Concurrent examination of resin lung casts from healthy koalas suggested greater laminar flow of air to the left caudal lung lobe in koalas. Actinomyces spp. have been reported as commensals of the oral microbiome in other species, and an association with similar pulmonary lesions in other species. Considering the predilection for involvement of the left caudal lung lobe, aspiration is suggested as the likely cause in some cases of pulmonary actinomycosis in koalas. Pulmonary actinomycosis has not been previously described in koalas and further work needs to be undertaken in order to classify this organism within the Actinomyces genus.
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Affiliation(s)
| | - Ken Lee
- University of Adelaide, Adelaide, South Australia, Australia
| | | | - David J McLelland
- University of Adelaide, Adelaide, South Australia, Australia.,Adelaide Zoo, ZoosSA, Adelaide, South Australia, Australia
| | - Anthony Wilkes
- University of Adelaide, Adelaide, South Australia, Australia
| | - Philip S Bird
- The University of Queensland, Gatton, Queensland, Australia
| | - Darren J Trott
- University of Adelaide, Adelaide, South Australia, Australia
| | | | | | - Lucy Woolford
- University of Adelaide, Adelaide, South Australia, Australia
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Abstract
ABSTRACT Capnocytophaga canimorsus is a bacteria commonly found in the normal oral cavity of dogs that can cause bacteremia in immunocompromised patients following a dog bite. This case describes sepsis and disseminated intravascular coagulation associated with C. canimorsus in a patient with a history of alcohol abuse. Clinicians must be alert to the risk factors for this infection and provide appropriate prophylaxis following dog bites.
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Affiliation(s)
- Madison A Hexter
- Madison A. Hexter practices in the Department of Pulmonology and Critical Care Medicine at OhioHealth Riverside Methodist Hospital in Columbus, Ohio. The author has disclosed no potential conflicts of interest, financial or otherwise
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Modak BK, Gorai P, Pandey DK, Dey A, Malik T. An evidence based efficacy and safety assessment of the ethnobiologicals against poisonous and non-poisonous bites used by the tribals of three westernmost districts of West Bengal, India: Anti-phospholipase A2 and genotoxic effects. PLoS One 2020; 15:e0242944. [PMID: 33253320 PMCID: PMC7703885 DOI: 10.1371/journal.pone.0242944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/12/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction To explore the ethnobiological wisdom of the tribals of three western districts of West Bengal, India against poisonous and non-poisonous bites and stings, a quantitative approach was adopted. These age-old yet unexplored knowledge can be utilized in finding lead-molecules against poisonous and non-poisonous animal-bites. Further, an evidence-based approach is needed to assess the venom-neutralization ability of plants by experimental studies. Materials and methods During 2008–2009 and 2012–2017, 11 ethnomedicinal surveys were carried out to explore the use of medicinal flora and fauna via conducting open semi-structured interviews with 47 traditional healers (THs) or informants. The retrieved dataset was statistically evaluated using seven quantitative-indexes: use-value (UV), informants'-consensus-factor (ICF), fidelity-level (FL), relative-importance (RI), cultural importance-index (CI), index of agreement on remedies (IAR) and cultural agreement-index (CAI). Anti-phospholipaseA2 (PLA2) properties of selected plant extracts were also examined. In addition, the cytotoxicity and genotoxicity of the water extract of the plants showing high FL as well as significant PLA2 inhibitory potential were investigated using Allium cepa root tip assay. Results A total of 41 traditional-formulations (TFs) containing 40 plant species (of 39 genera from 28 families) and 3 animal species were prescribed by the THs. Fabaceae exhibited most number of medicinal plants. Piper nigrum (1.78) and Apis cerana indica and Crossopriza lyoni (both 0.21) exhibited the highest UV among the plants and the animals respectively. Stinging of centipede and dog/cat/hyena bite displayed highest ICF (1.00 each). Among the plants, the maximum RI (0.91) and CI (4.98) values were observed for Aristolochia indica. IAR (1.00) was recorded maximum for Achyranthes aspera, Gloriosa superba, Lycopodium cernuum, Smilax zeylanica and Streblus asper. Maximum CAI value was noted for Piper nigrum (5.5096). Among the animals, Apis cerana indica (0.31) and Crossopriza lyoni (1.52) displayed the highest RI and CI values respectively. Crossopriza lyoni (0.99) and Apis cerana indica (1.3871) exhibited maximum IAR and CAI values respectively. Plants showing higher FL exhibited higher anti-PLA2 activity via selective inhibition of human-group PLA2. In addition, Allium cepa root tip assay has indicated the safety and/or toxicity of the plant parts prescribed by the THs. Root water extracts of Aristolochia indica and Gloriosa superba exhibited significant genotoxicity and cytotoxicity. Conclusions Three western districts of West Bengal is the natural abode for many tribal and non-tribal communities. A noteworthy correlation was established between the plants used against poisonous-bites and their anti-PLA2 activity. A few plant parts used by the THs also exhibited high toxicity. Such alternative medical practices serve as the only option in these underprivileged and backward areas during medical-exigencies.
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Affiliation(s)
- Biplob Kumar Modak
- Department of Zoology, Sidho-Kanho-Birsha University, Lagda, West Bengal, India
| | - Partha Gorai
- Department of Zoology, Sidho-Kanho-Birsha University, Lagda, West Bengal, India
| | - Devendra Kumar Pandey
- Department of Biotechnology, Lovely Faculty of Technology and Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, West Bengal, India
- * E-mail: (TM); (AD)
| | - Tabarak Malik
- Department of Medical Biochemistry, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail: (TM); (AD)
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Khan A, Al-Kathiri WH, Balkhi B, Samrkandi O, Al-Khalifa MS, Asiri Y. The burden of bites and stings management: Experience of an academic hospital in the Kingdom of Saudi Arabia. Saudi Pharm J 2020; 28:1049-1054. [PMID: 32792849 PMCID: PMC7414059 DOI: 10.1016/j.jsps.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/03/2020] [Indexed: 10/25/2022] Open
Abstract
Purpose The main aim of this study is to estimate the economic burden and prevalence of bites and stings injuries in Saudi Arabia. Methods A retrospective, cross-sectional study was conducted at King Saud University Medical City (KSUMC) for all bites and stings cases presented to the Emergency Department (ED) between the period June 2015 and May 2019. Results A total of 1328 bites and stings cases were treated in the ED at KSUMC. There were 886 insect bites and stings cases, 376 animal bites, 22 human bites, 34 scorpion stings, and ten snakebites. Most cases were reported in April - June. Females account for 62% of the reported cases, and the mean age was 24 years old. The total management cost of bite and sting cases during the study period was 3.4 million Saudi Riyal (SR). The spending cost of the management of animal bites was the highest as it cost 1,681,920.76 SR, followed by insect's management costing 1,228,623.68 SR. Conclusion Bites and stings have a considerable health care burden on our society. Although the vast majority of the cases were not associated with a severe life-threatening condition, many were visit ED and associated with high medical costs. Increased awareness of the hazards of animal-related injuries, especially during spring and summer, where most cases take place may lower its incidence and decrease EDs visits.
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Affiliation(s)
- Anas Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Waad H Al-Kathiri
- Department of Clinical Pharmacy Services, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Bander Balkhi
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomic Research Unit, King Saud University, Riyadh, Saudi Arabia
| | - Osama Samrkandi
- Department, Prince Sultan bin Abdulaziz College for EMS, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | - Yousef Asiri
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Mochizuki Y, Ishikawa H, Sato A, Yamada K, Takesue Y, Gomi F. Pasteurella multocida-induced endophthalmitis after a cat scratch. Am J Ophthalmol Case Rep 2020; 18:100711. [PMID: 32322756 PMCID: PMC7170947 DOI: 10.1016/j.ajoc.2020.100711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/26/2019] [Accepted: 04/12/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose To report the case of a Japanese girl with a perforating ocular injury caused by a cat scratch, resulting in Pasteurella multocida-induced endophthalmitis. Observations A 10-year-old girl presented with a red eye, eye pain, and blurred vision in her right eye immediately after receiving a cat scratch. We performed lensectomy and vitrectomy for endophthalmitis 4 hours after her arrival. After culturing a sample of the vitreous humor, Pasteurella multocida was identified, and the antibiotic was changed to ampicillin. The best-corrected visual acuity of her right eye improved to 20/20 6 months after surgery. Conclusions and importance We present a rare case of Pasteurella multocida-induced endophthalmitis after a cat scratch. Our findings suggest the great importance of identifying the responsible bacterium and using matched antibiotics as soon as possible in such cases to prevent vision loss.
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Affiliation(s)
- Yoshihito Mochizuki
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
| | - Hiroto Ishikawa
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
- Corresponding author. Department of Ophthalmology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan..
| | - Aki Sato
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
| | - Kumiko Yamada
- Department of Infection Control and Prevention, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
| | - Yoshio Takesue
- Department of Infection Control and Prevention, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
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Dog-bite-related attacks: A new forensic approach. Forensic Sci Int 2020; 310:110254. [PMID: 32200306 DOI: 10.1016/j.forsciint.2020.110254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 03/04/2020] [Accepted: 03/11/2020] [Indexed: 11/22/2022]
Abstract
Dog attacks today represent a health hazard considering that prevention strategies have not always been successful. The identification of the dog that attacked the victim is necessary, considering the civil or criminal consequences for the animal's owner. An accurate scene analysis must be performed collecting a series of important information. Forensic investigations in dog attacks involve different methods, such as the evaluating of the canine Short Tandem Repeat (STR) typing in saliva traces on wounds or bite mark analysis, however, these techniques cannot always be applied. The effort to find new methods to identify the dog that attacked the victim represents a very interesting field for the forensic community. This study aims to propose an innovative approach, based on the identification of the victim's profile in the dog's mouth, using a buccal swab on the suspected aggressor dog, to find the victim's genetic profile. In addition, a further goal of this study is to determine the persistence time of hexogen DNA in the dog's mouth to define a timeframe for performing this particular technique. For this purpose, ten different dogs were used to aggressively bite a bovine sample (reference sample) to simulate the victim. For each dog two buccal swabs were taken at different time intervals: 30', 45', 60', 90', 120', 150', 180' and 240'. The typing of the swabs provided an interpretable profile after 45' while traces of bovine profile were found until 150' after the dog attack simulation. These results could be improved using the human identification kit, which is more sensitive. In the light of this experimental study, the forensic community should consider using this approach in real casework studies with the aim of collecting new data, validating this technique for forensic use.
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Hernon T, Langley-Hobbs SJ. Traumatic fragmentation and concurrent infection of a palmar sesamoid in a cat. JFMS Open Rep 2020; 6:2055116920907417. [PMID: 32158548 PMCID: PMC7047238 DOI: 10.1177/2055116920907417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 9-year-old neutered male domestic shorthair cat was referred for assessment of a chronic non-weightbearing left forelimb lameness that had an acute onset following a suspected cat bite to the distal limb 4 weeks previously. There was minimal improvement following conservative management. On examination there was discomfort on palpation of the left palmar metacarpal region. An orthopaedic examination performed under sedation identified a moderate effusion of the left fourth metacarpophalangeal joint. A CT scan was performed, which identified fragmentation of the medial palmar sesamoid of the fourth digit (sesamoid V). Arthrocentesis of the fourth metacarpophalangeal joint identified septic inflammation. Surgical removal of the fragmented palmar sesamoid was performed and was submitted for histopathology and bacteriology analysis. Postoperative CT confirmed the removal of all fragments. Pasteurella species were isolated from the sesamoid fragments. Histopathology revealed osteomyelitis, neutrophilic inflammation and multifocal necrosis, with evidence of fibrosis present. The cat was re-examined 3 months postoperatively, at which point there was no evidence of lameness and orthopaedic examination of the limb was unremarkable. Relevance and novel information To our knowledge, this is the first reported case of fragmentation of a palmar sesamoid in a cat. This case study describes the diagnosis and the successful management of a cat with fragmentation of a palmar sesamoid, following an altercation with another cat.
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Affiliation(s)
- Tom Hernon
- Langford Veterinary Services, Small Animal Hospital, University of Bristol, Langford, Bristol, UK
| | - Sorrel J Langley-Hobbs
- Langford Veterinary Services, Small Animal Hospital, University of Bristol, Langford, Bristol, UK
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Bites and Stings. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_54-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bhaumik S, Kirubakaran R, Chaudhuri S. Primary closure versus delayed or no closure for traumatic wounds due to mammalian bite. Cochrane Database Syst Rev 2019; 12:CD011822. [PMID: 31805611 PMCID: PMC6894945 DOI: 10.1002/14651858.cd011822.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mammalian bites are a common presentation in emergency and primary healthcare facilities across the world. The World Health Organization recommends postponing the suturing of a bite wound but this has not been evaluated through a systematic review. OBJECTIVES To assess the effects of primary closure compared with delayed closure or no closure for mammalian bite wounds. SEARCH METHODS In July 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA We included randomised controlled trials which compared primary closure with delayed or no closure for traumatic wounds due to mammalian bite. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text publications, applied the inclusion criteria, and extracted data. We pooled data using a random-effects model, as appropriate. We used the Cochrane 'Risk of bias' tool and assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We found three trials (878 participants) that compared primary closure with no closure for dog bites and one trial (120 participants) that compared primary closure with delayed closure. No other mammalian bite studies were identified. The trials were from the UK (one trial), Greece (one trial) and China (two trials). Overall, participants from both sexes and all age groups were represented. We are uncertain whether primary closure improves the proportion of wounds which are infection-free compared with no closure, as the certainty of evidence for this outcome was judged to be very low (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.97 to 1.05; 2 studies, 782 participants; I2 = 0%). We downgraded the evidence by one level for high risk of bias and two levels for imprecision. There is no clinically important difference in cosmesis (acceptable physical/cosmetic appearance) of dog bite wounds when primary closure is compared with no closure (mean difference (MD) -1.31, 95% CI -2.03 to -0.59; 1 study, 182 participants). The certainty of evidence for this outcome was judged to be moderate (we downgraded our assessment by one level for imprecision). We are uncertain whether primary closure improves the proportion of dog bite wounds that are infection-free compared with delayed closure, as the evidence for this outcome was judged to be very low (RR 0.98, 95% CI 0.90 to 1.07; 1 study, 120 participants; I2 = 0%). We downgraded the evidence by one level for high risk of bias and two levels for imprecision. None of the four trials reported any adverse outcomes such as death or rabies but they were, in any case, unlikely to have been large enough to have satisfactory power to provide precise estimates for these. Important outcomes like time to complete wound healing, proportion of wounds healed, and length of hospital stay were not evaluated. AUTHORS' CONCLUSIONS All the studies we identified concerned dog bites. There is no high-certainty evidence to support or refute existing recommendations concerning primary closure for dog bites. The potential benefits and harms of primary closure compared with delayed or no closure for mammalian bites remain uncertain and more robust trials are needed.
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Affiliation(s)
- Soumyadeep Bhaumik
- The George Institute for Global Health311‐312, Third Floor, Elegance TowerPlot No. 8, Jasola District CentreNew DelhiIndia110025
| | - Richard Kirubakaran
- Christian Medical CollegeCochrane South Asia, Prof. BV Moses Centre for Evidence‐Informed Healthcare and Health PolicyCarman Block II FloorCMC Campus, BagayamVelloreIndia632002
| | - Sirshendu Chaudhuri
- Christian Medical CollegeWellcome Trust Research Laboratory, Division of Gastrointestinal SciencesIda Scudder RoadVelloreTamil NaduIndiaPIN 632004
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Severe Sea Lion Bites in Urban Cold-Water Swimmers. J Emerg Med 2019; 57:859-865. [PMID: 31708308 DOI: 10.1016/j.jemermed.2019.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/30/2019] [Accepted: 09/09/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND A series of sea lion bites in open-water swimmers recently gained the attention of the national and international media. Pinniped (the clade including seals and sea lions) bites historically have been in people who hunt or handle marine mammals. As populations of humans and pinnipeds continue to grow, interactions with animals by those participating in recreational activities are likely to become more frequent. CASE REPORTS In December of 2017 and January of 2018, four sea lion (Zalophus californianus) bites in humans occurred at a popular open-water recreational swimming area in San Francisco, California. Three swimmers required treatment at a local trauma center and two required surgery. Two of the wounds were potentially life threatening; one swimmer required a field tourniquet to stop bleeding from the antecubital fossa, and the bite in another narrowly missed the femoral artery. The purpose of this report is to offer an in-depth discussion of antimicrobial use and rabies postexposure prophylaxis in patients with severe pinniped bites. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Information from this report can be used in conjunction with input from local experts to develop a thoughtful therapeutic plan for patients with severe pinniped bites. Doxycycline is the first-line antibiotic therapy, but broader coverage may be needed for severe wounds with the potential for contamination. The likelihood of rabies is low, and rabies postexposure prophylaxis should be reserved for cases that involve unusually aggressive animal behavior or other factors suggestive of rabies.
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Williams EJ, Blackwell E. Managing the Risk of Aggressive Dog Behavior: Investigating the Influence of Owner Threat and Efficacy Perceptions. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2019; 39:2528-2542. [PMID: 31136682 DOI: 10.1111/risa.13336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/24/2019] [Accepted: 05/05/2019] [Indexed: 06/09/2023]
Abstract
Aggressive behavior in pet dogs is a serious problem for dog owners across the globe, with bite injuries representing a serious risk to both people and other dogs. The effective management of aggressive behavior in dogs represents a challenging and controversial issue. Although positive reinforcement training methods are now considered to be the most effective and humane technique to manage the risk of aggression, punishment-based methods continue to be used. Unfortunately, there has been little scientific study into the various factors influencing whether dog owners choose to use positive reinforcement techniques to manage aggression in their dogs. As such, current understanding of how best to encourage and support dog owners to use these methods remains extremely limited. This article uses a survey methodology based on protection motivation theory (PMT) to investigate the factors that influence owner use of positive reinforcement methods to manage aggressive behavior, in an attempt to understand potential barriers and drivers of use. In addition, the article provides an initial exploration of the potential role of wider psychological factors, including owner emotional state, social influence, and cognitive bias. Findings show that the perceived efficacy of positive reinforcement methods and the perceived ability of owners to effectively implement the technique are both key factors predicting future intentions and current reported use. Future interventions should focus on enhancing owner confidence in the effective use of positive reinforcement techniques across multiple scenarios, as well as helping owners manage their own emotional responses when they encounter challenging situations and setbacks.
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Affiliation(s)
- Emma J Williams
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Emily Blackwell
- Bristol Veterinary School, University of Bristol, Bristol, UK
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41
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Abstract
Animal bites account for 1% of ED visits and more than $50 million in healthcare costs annually in the United States. Managing bite wounds can be challenging and providers must consider the patient's tetanus status, species of animal inflicting the bite, and infection risk. This article describes treatment and care of bites and when rabies prophylaxis is indicated.
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Özavci V, Erbas G, Parin U, Yüksel HT, Kirkan Ş. Molecular detection of feline and canine periodontal pathogens. Vet Anim Sci 2019; 8:100069. [PMID: 32734086 PMCID: PMC7386636 DOI: 10.1016/j.vas.2019.100069] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 01/14/2023] Open
Abstract
It is concluded that the feline oral flora is highly diverse than canine oral flora. Porphyromonas gingivalis, Prevotella nigrescens and Porphyromonas gulae were the dominant species in cats and dogs. T. forsythia, C. ochracea, and C. sputigena in cats and T. forsythia, C. ochracea, C. sputigena T. denticola and, E. corrodens, in dogs showed that the prevalence was lower than 10%. E. corrodens in cats and, P. intermedia, A. actinomycetemcomitans, and C. rectus in dogs were also isolated from the swab samples with less than 30% percentage. A balanced diet for cats and dogs should be provided to reduce the formation of residues in the oral flora. Daily rinsing with antiseptic solutions may also be helpful against the development of periodontal pathogens.
Periodontal disease is the most common infectious disease of cats and dogs which are strongly associated with periodontal pathogens. The primary etiologic factor in the formation of periodontal disease is microbial dental plaque accumulation on teeth. In our research, we aimed to investigate the presence of periodontal disease-related bacterial species in dental plaques of cats and dogs. Specimens collected from 50 cats and 51 dogs with periodontal disease examined in terms of periodontal pathogens by polymerase chain reaction (PCR) using primers directed to 16S rRNA and tdpA genes. Our findings indicate the presence of periodontal disease-related pathogens, especially Porphyromonas gingivalis (cats 96%, dogs 88%), Prevotella nigrescens (cats 90%, dogs 57%) and, Porphyromonas gulae (cats 70%, dogs 39%). In addition, the prevalence of Tannerella forthysia (cats 2%, dogs 4%) well-known pathogen in cats and dogs were isolated with an extremely low percentage. Furthermore, our results suggest that the feline oral cavity microbiota has considerably more diversity than dogs. Consequently, daily oral hygiene practices may become essential for controlling the pathogenic bacteria which have clinical importance and in preventing the propagation of microorganisms in the oral cavity of cats and dogs.
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Affiliation(s)
- Volkan Özavci
- Department of Microbiology, Faculty of Veterinary Medicine, Yozgat Bozok University, Yozgat, Turkey
- Corresponding author.
| | - Göksel Erbas
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Uğur Parin
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Hafize Tuğba Yüksel
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Şükrü Kirkan
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
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Kheiran A, Palial V, Rollett R, Wildin CJ, Chatterji U, Singh HP. Cat bite: an injury not to underestimate. J Plast Surg Hand Surg 2019; 53:341-346. [DOI: 10.1080/2000656x.2019.1637750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Amin Kheiran
- Leicester Orthopaedics, Department of Hand Surgery, Leicester Royal Infirmary, Leicester, UK
| | - Vishal Palial
- Leicester Orthopaedics, Department of Hand Surgery, Leicester Royal Infirmary, Leicester, UK
| | - Rebecca Rollett
- Department of Plastic and Reconstructive Surgery, Leicester Royal Infirmary, Leicester, UK
| | - Clare J. Wildin
- Leicester Orthopaedics, Department of Hand Surgery, Leicester Royal Infirmary, Leicester, UK
| | - Urjit Chatterji
- Leicester Orthopaedics, Department of Hand Surgery, Leicester Royal Infirmary, Leicester, UK
| | - Harvinder P. Singh
- Leicester Orthopaedics, Department of Hand Surgery, Leicester Royal Infirmary, Leicester, UK
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Andrade BFMDC, Andrade TSDM, Queiroz LH. Human rabies post-exposure prophylaxis relative to the disease epidemiological status. CIENCIA & SAUDE COLETIVA 2019; 24:315-322. [PMID: 30698264 DOI: 10.1590/1413-81232018241.32832016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 03/18/2017] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the prophylactic measures adopted after attacks by dogs and cats in the main city of Northwester São Paulo State, based on the technical manual for post-exposure treatment, considering the not controlled (1990-1996) and controlled (1997-2010) rabies status. A retrospective analysis was done using the data from the SINAN records (W64-CID10) between 1990 and 2010. In most cases, the accidents were mild (76.9%), and biting animals were healthy (75.4%); therefore, no treatment was needed in 53.3% of the cases. In 64.6% of cases, the prescribed PEP treatment was inappropriate. The most indicated PEP treatments consisted of vaccine and RIG (43.4%), and either three doses of mouse brain vaccine or two doses of cell culture vaccine (76.5%), during the not controlled and controlled rabies periods, respectively. The treatment was more appropriate and followed the technical recommendations during controlled rabies periods compared to not controlled (p < 0.0001) periods. However, excessive application of RIG and rabies vaccine was observed in both periods.
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Affiliation(s)
- Bruno Fonseca Martins da Costa Andrade
- Programa de Pós-Graduação em Ciência Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista. R. Clóvis Pestana 793, Dona Amélia. 16050-680 Araçatuba SP Brasil.
| | | | - Luzia Helena Queiroz
- Programa de Pós-Graduação em Ciência Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista. R. Clóvis Pestana 793, Dona Amélia. 16050-680 Araçatuba SP Brasil.
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Dhillon J, Hoopes J, Epp T. Scoping decades of dog evidence: a scoping review of dog bite-related sequelae. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2019; 110:364-375. [PMID: 30378009 PMCID: PMC6964408 DOI: 10.17269/s41997-018-0145-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/05/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES There has been considerable literature published focusing on various sequelae to dog bites over the last three decades. Much of the literature has focused on rabies, particularly canine rabies variant, which accounts for the majority of rabies deaths worldwide. This paper describes the complications, the pathogens, and other sequelae resulting from dog bites documented in the literature. METHODS This paper used evidence found through a scoping review which charted the published peer-reviewed and non-peer-reviewed gray literature and online information relating to dog bite incidents. Each complication or sequela was additionally assessed from the viewpoint of Canadian Indigenous, rural, and geographically remote communities, which experience a high number of dog bite incidents annually. SYNTHESIS Peer-reviewed literature (N = 693; case report, original research, and review articles) provided detailed information on specific pathogens, infections, and diseases of interest, especially rabies. However, in addition to these, the sequelae from dog bites may include moderate to severe injuries that further result in anxiety around dogs or post-traumatic stress disorder (PTSD). CONCLUSIONS While a lot of focus in the literature is on rabies as a sequela to dog bites, the impacts of anxiety and PTSD are not as well articulated. Treatment of dog bite injuries may be standardized; however, improved collaborations between diverse health professionals (physicians, veterinarians, counseling services, animal behaviourists, and others) could be of considerable benefit in decreasing the effects of dog bites.
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Affiliation(s)
- Jasmine Dhillon
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
- Animal Health Science Directorate, Canadian Food Inspection Agency, 1400 Merivale Rd, Ottawa, ON, K1A 0Y9, Canada
| | | | - Tasha Epp
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada.
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Capnocytophaga canimorsus as Cause of Fatal Sepsis. Case Rep Infect Dis 2019; 2019:3537507. [PMID: 31240140 PMCID: PMC6556245 DOI: 10.1155/2019/3537507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/02/2019] [Indexed: 11/17/2022] Open
Abstract
A rare consequence of dog bites is the infection with Capnocytophaga canimorsus, and only a few cases have been documented. We describe a 41-year-old, formerly healthy woman who died from septic shock and multiorgan failure. It is the first case of a young individual without obvious immunosuppression.
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SAĞKAN ÖZTÜRK A, KÖSE Sİ. Gizli Tehdit: Et Yiyen Zoonoz Bakteriler. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2019. [DOI: 10.17517/ksutfd.438344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Ujvári B, Weiczner R, Deim Z, Terhes G, Urbán E, Tóth AR, Magyar T. Characterization of Pasteurella multocida strains isolated from human infections. Comp Immunol Microbiol Infect Dis 2019; 63:37-43. [PMID: 30961816 DOI: 10.1016/j.cimid.2018.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 12/12/2018] [Accepted: 12/21/2018] [Indexed: 11/16/2022]
Abstract
Isolates of Pasteurella multocida recovered from infected humans (n = 15) were characterized by traditional and molecular microbiological methods and were compared with cat-derived strains (n = 5). The most prevalent subspecies among strains from human infections was P. multocida subsp. septica (80%), and nearly all isolates showed a similar combination of virulence-associated genes. MLST analysis classified the 20 P. multocida strains into 16 different sequence types, and we assigned 11 new sequence types (ST), however, only one of those (ST 334) was shared by two human and one cat isolates. P. multocida subsp. septica strains formed a distinct phylogenetic group within the species. The strains showed resistance to erythromycin, clindamycin and sulfamethoxazole, and with two exceptions, resistance to tilmicosin was also detected. Each strain was susceptible to ampicillin, streptomycin, gentamycin, tetracycline, doxycycline, cefazolin, cefpodoxime, chloramphenicol, florfenicol and enrofloxacin. Common characteristics (virulence profile and antibiotic sensitivity pattern) shared by strains isolated from humans and cats support the view that domestic cats may serve as a potential reservoir for P. multocida.
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Affiliation(s)
- B Ujvári
- Institute for Veterinary Medical Research, Centre for Agricultural Research, Hungarian Academy of Sciences, P.O. Box 18, 1581 Budapest, Hungary
| | - R Weiczner
- Albert Szent-Györgyi Health Centre, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 107, 6725 Szeged, Hungary
| | - Z Deim
- Department of Biotechnology, University of Szeged, Közép fasor 52, 6726 Szeged, Hungary
| | - G Terhes
- Faculty of Medicine, Institute of Clinical Microbiology, University of Szeged, Semmelweis u. 6, 6725 Szeged, Hungary
| | - E Urbán
- Faculty of Medicine, Institute of Clinical Microbiology, University of Szeged, Semmelweis u. 6, 6725 Szeged, Hungary
| | - A R Tóth
- Med-Forensic Bt., Ady Endre u. 26, 6762 Sándorfalva, Hungary
| | - T Magyar
- Institute for Veterinary Medical Research, Centre for Agricultural Research, Hungarian Academy of Sciences, P.O. Box 18, 1581 Budapest, Hungary.
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[Surgical treatment of bites]. OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2018; 30:321-341. [PMID: 30209521 DOI: 10.1007/s00064-018-0563-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/21/2018] [Accepted: 06/07/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Thorough and profound debridement for acute bite injuries while sparing nerves, vessels and tendons. INDICATIONS Acute traumatic and late presented bite injuries. CONTRAINDICATIONS General contraindication for anesthesia or surgery. SURGICAL TECHNIQUE Extensive flabellate local anesthesia/general anesthesia, wound irrigation using 0.9% NaCl or antiseptic solutions, removal of avital tissues, wound debridement, wound edge excision, anew extensive irrigation, drainage if necessary, wound closure where applicable (except older or punctual deep injuries), bandage, elastic wrapping and immobilization. If necessary, plastic surgery with coverage of remaining defects. POSTOPERATIVE MANAGEMENT Immobilization with initially daily wound evaluation, removal of drainage/loop on postoperative day 2; if necessary, antibiotic therapy with amoxicillin and clavulanic acid in high-risk wounds (e.g., puncture wounds, joint or bone involvement, extensive soft tissue squeezing), suture removal on day 10-12 after surgery. RESULTS Of 142 bite injuries that were treated and retrospectively evaluated, 46% were caused by dogs and 32% by cats. Patients were on average 44 years old; 55% of all dog bites affected women, but 67% of all cat bites. In 48% of the cases, general anesthesia was necessary. The postoperative infection rate was 6.3%.
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