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El-Menyar A, Khan NA, Naqvi SGA, Al-Thani H. Patterns of horse and camel- related injuries: A descriptive analysis from a national trauma registry (2007-2021). Injury 2023; 54:111093. [PMID: 37806821 DOI: 10.1016/j.injury.2023.111093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The large animal-related injuries are emerging major trauma but remain underestimated public health problem worldwide. We aimed to determine the incidence, clinical characteristics, mechanisms and patterns of horse and camel-related injuries (HCRIs) in a Middle Eastern country. METHODS A retrospective analysis of all patients who were hospitalized due to HCRIs was conducted. Data included patient's demographics, mechanism of injury, anatomical location and severity of injury, and hospital outcomes. RESULTS Between November 2007 and December 2021, there were 273 hospitalized patients with HCRIs representing1.3 % of the total trauma admissions. Of these, 145 (53.1 %) and 128 (46.9 %) were horse (HRI) and camel-related injuries (CRI) respectively. The most common presenting age group of the cohort was 20-29 years and 88 % were males. Patients with HRIs were younger (27.5 ± 11 years) than CRIs (34 ± 13.5 years). Injuries to the extremities were the most common (62 % vs. 40 %), followed by the head injury (25.5 % vs. 31 %) among the HRIs and CRIs, respectively. The most common mechanism of injury was falling off followed by getting kicked by the HCRIs. Major trauma (ISS ≥12) was found in 23 % of HRIs (47.5 %) and CRIs (52.5 %). Only 5 % of patients had shock index >0.90 on admission; two thirds were due to CRIs. There were four fatalities (1.5 %), all attributed to traumatic brain injury, of which three were due to HRIs and one due to CRIs. CONCLUSION This study reveals that HCRIs predominantly affect young adult males and may involve serious injuries, exhibit distinct injury patterns, however, it is associated with low mortality. Preventive measures need to be revisited.
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Affiliation(s)
- Ayman El-Menyar
- Department of Surgery, Clinical Research, Trauma & Vascular Surgery, Hamad General Hospital, Doha, Qatar; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
| | - Naushad A Khan
- Department of Surgery, Clinical Research, Trauma & Vascular Surgery, Hamad General Hospital, Doha, Qatar
| | - Syed G A Naqvi
- Department of Radiology, Hamad General Hospital, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar
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Al-Ali MA, Mousa HM, Nibelle I, Hefny AF. Camel-Related Facial Injuries: A Seven-Year Retrospective Study. Clin Pract 2023; 13:889-897. [PMID: 37623262 PMCID: PMC10453722 DOI: 10.3390/clinpract13040081] [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: 05/19/2023] [Revised: 07/12/2023] [Accepted: 07/23/2023] [Indexed: 08/26/2023] Open
Abstract
Facial injuries caused by camels can be associated with adverse long-term effects on patients' quality of life. We aimed to investigate camel-related facial injuries in Al-Ain City, UAE, focusing on their incidence, types, mechanisms, anatomical distribution, and outcomes, to enhance preventive measures. We retrospectively collected data from all patients who were admitted to our hospital with camel-related facial injuries from January 2014 through January 2021. Thirty-six patients were included; all were males, with a mean (range) age of 31 (14-66) years, 29 (80.5%) were camel caregivers. The most common mechanisms of injury were falling while riding a camel and camel kicks. The head was the most commonly injured region in 52.7%. Twenty-three (63.8%) patients had facial bone fractures. The middle third of the face accounted for 71.4% of the bony fractures. The most performed surgical procedures in our patients were soft tissue laceration repair and open reduction with internal fixation of fractures (ORIF). Camel-related facial injuries affect young adult male camel caregivers working on camel farms. Orbital and maxillary bone fractures are the most predominant fractures requiring operative management. Legislation for compulsory helmet usage may reduce the incidence of these injuries and their serious consequences.
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Affiliation(s)
- Mohamed A. Al-Ali
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates; (M.A.A.-A.); (H.M.M.)
- Department of Otolaryngology, Al Ain Hospital, Abu Dhabi, United Arab Emirates;
| | - Hussam M. Mousa
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates; (M.A.A.-A.); (H.M.M.)
| | - Isabelle Nibelle
- Department of Otolaryngology, Al Ain Hospital, Abu Dhabi, United Arab Emirates;
| | - Ashraf F. Hefny
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates; (M.A.A.-A.); (H.M.M.)
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Neville SE, Zidan T, Williams A, Rotabi-Casares KS. Child maltreatment and protection in the Arab Gulf Cooperation Council countries: A scoping review. CHILD ABUSE & NEGLECT 2022; 134:105924. [PMID: 36244212 PMCID: PMC10511143 DOI: 10.1016/j.chiabu.2022.105924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/08/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Research on child maltreatment and protection in the Arab Gulf Cooperation Council countries-Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE)-is limited but growing, as is child protection as a sector. OBJECTIVES We aimed to identify themes and gaps in existing research on child maltreatment and protection, identify opportunities for building capacity in research and practice. PARTICIPANTS AND SETTING N/A. METHODS We conducted a scoping review of empirical studies published in peer-reviewed journals in English and Arabic and reported methods and findings according to the PRISMA-ScR reporting protocol. Articles were coded by country, topic of research, and type of abuse studied, if any. RESULTS Our database search returned 6109 articles and 160 articles were included in our review. Themes included (1) prevalence, incidence, and characteristics of maltreatment, (2) outcomes associated with maltreatment, (3) attitudes, awareness, and reporting, (4) accidental injury and death potentially associated with neglect, (5) policy and practice. Eighty-seven articles studied Saudi Arabia, while 28 studied the UAE, 21 Kuwait, 13 Qatar, 12 Oman, and 11 Bahrain. Physical abuse was studied in 77 articles, followed by sexual abuse in 54 articles and emotional abuse in 54. CONCLUSION Although the medical community produces an encouraging volume of child maltreatment research, gaps remain. Intervention research is lacking, and further inquiry into family dynamics, culture, and spirituality could inform the development of effective interventions. Cross-sectoral collaboration among education, social work, law enforcement, and healthcare is also needed to safeguard children's rights in the GCC.
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Affiliation(s)
| | - Tarek Zidan
- Indiana University School of Social Work, 1800 Mishawaka Ave., South Bend, IN, USA.
| | - Adam Williams
- Boston College Social Work Library, 140 Commonwealth Ave., Chestnut Hill, MA, USA.
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Al-Ali MA, Alao DO, Abu-Zidan FM. Factors affecting mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates. PLoS One 2022; 17:e0278381. [PMID: 36445878 PMCID: PMC9707776 DOI: 10.1371/journal.pone.0278381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/15/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Facial injuries affect one-third of severely injured patients. These injuries have devastating long-term negative impacts on quality of life. We aimed to study the epidemiology of facial injuries and factors affecting the mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates. METHODOLOGY This is a retrospective analysis of prospectively collected data from Al-Ain Hospital Trauma Registry. All patients with facial injury who were hospitalized for more than 24 hours or who died after arrival at the hospital during the period from January 2014 to December 2017 were studied. Two sample data analysis was used to compare patients who died and those who survived. Significant factors were then entered into a backward logistic regression model to define factors affecting mortality. RESULTS 408 patients having a mean age of 31.9 years were studied, 87.3% were males. The main mechanisms of injury were road traffic collisions (52.2%) and fall from height (11.3%). 289 (70.8%) patients had associated injuries which were mainly in the head and chest. The backward logistic regression model showed that the Glasgow Coma Scale (GCS) was the only factor that predicted mortality, p<0.0001 with the best cut-off point of 7.5, having a sensitivity of 0.972 and a specificity of 0.8. The ROC had an area under the curve of 0.924. CONCLUSION The majority of facial injury patients in our setting are young males who were involved in road traffic collisions or falls from height. The most important factor predicting the mortality of these patients was the low GCS. Those having a GCS of 8 and more had a better chance of survival. This information is very important when counseling patients or their relatives for facial surgery.
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Affiliation(s)
- Mohamed A. Al-Ali
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Department of Otolaryngology, Al-Ain Hospital, Al-Ain, United Arab Emirates
- * E-mail:
| | - David O. Alao
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Fikri M. Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Balac K, Al-Ali MA, Hefny AF, Mohamed BK, Abu-Zidan FM. Surgical management of camel-related craniofacial injuries. Afr Health Sci 2022; 22:407-415. [PMID: 36910381 PMCID: PMC9993317 DOI: 10.4314/ahs.v22i3.44] [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: 11/16/2022] Open
Abstract
Background There are no studies focused on the types and management of camel-related craniofacial injuries. Objectives We aimed to analyze the pattern of injuries that required surgical management and their specific operative treatment. Methods We prospectively collected data of all patients who were admitted to Al Ain Hospital with camel-related craniofacial injuries that were treated operatively during the period of January 2015 to January 2020. Results Eleven patients were studied; all were males having a median (range) age of 29 (19-66) years. Falling from a camel was the most common mechanism of injury (45.5 %) followed by camel bite (36.4 %). The most common injured region was the middle third of the face, which accounted for 56.5% of the bony fractures. Zygomatico-maxillary complex fractures were present in 60% of patients who fell while riding a camel. The most common surgical procedure performed in our patients was an open reduction with internal fixation (54.5%). There was no mortality. Conclusions camel-related craniofacial injuries are complex. The main mechanism of injury is falling from a camel on the face causing fractures of the zygomatico-maxillary complex. These fractures usually need open reduction with internal fixation. Taking safety precautions may help in injury prevention.
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Affiliation(s)
- Korana Balac
- Department of Surgery, Al Ain Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Mohamed A Al-Ali
- Department of Otolaryngology, Al Ain Hospital, Al Ain, Abu Dhabi, United Arab Emirates.,Department of Surgery, College of Medicine and Health Sciences, UAE University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Ashraf F Hefny
- Department of Surgery, Al Ain Hospital, Al Ain, Abu Dhabi, United Arab Emirates.,Department of Surgery, College of Medicine and Health Sciences, UAE University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Baraa K Mohamed
- Department of Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Fikri M Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
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Khan N, Al-Thani H, El-Menyar A. Reply to the letter to the Editor: The nature and consequences of camel-related injuries: A scoping review with special reference to Arab Middle Eastern countries. Injury 2022; 53:2690-2691. [PMID: 35643560 DOI: 10.1016/j.injury.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/08/2022] [Indexed: 02/02/2023]
Affiliation(s)
| | | | - Ayman El-Menyar
- Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medical College, Doha, Qatar.
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The nature and consequences of camel-related injuries: Is this a scoping review? Injury 2022; 53:2693. [PMID: 35365352 DOI: 10.1016/j.injury.2022.03.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/23/2022] [Indexed: 02/02/2023]
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The nature and consequences of camel-related injuries: A scoping review with special reference to Arab Middle Eastern countries. Injury 2022; 53:1319-1328. [PMID: 35101258 DOI: 10.1016/j.injury.2022.01.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/03/2022] [Accepted: 01/22/2022] [Indexed: 02/02/2023]
Abstract
Animal-related injuries are a substantial but under-reported, emerging public health problem contributing considerably to worldwide morbidity and death. Understanding the behavior of big animals may help in injury prevention. Camels are large long-neck ungulates of the genus Camelus that have been domesticated for millennia as a mode of transportation, race, and food source. Camel-related injuries are not well studied when compared with other animals' injuries. Camels can occasionally be very hostile to humans, inflicting serious injuries. These injuries can be caused by camel bites, falls from their backs, kicks, or collisions with motor vehicles. The relative magnitude of each mechanism has never been extensively studied in the literature. Furthermore, the incidence of camel-related injuries is not well reported worldwide. Camels remain a potential cause of serious injuries and a public health problem for some countries in the Middle East. There are gaps in the incidence, risk factors and mechanism, distribution of camel-related injuries. We aimed to summarize the data and draw conclusions pertaining not just to the most common mechanism of injury but to demographics, incidence, severity, and appropriate methods of prevention of camel-related injuries. This scoping review findings will help for better understanding of the nature and consequences of camel-related injuries, and to improve the existing preventive and management strategies.
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Zaki HA, Shaban EE, Shaban AE, Hodhod H, Elmoheen A. Camel Bite Injury to the Face in an Adult Patient: Skin Closure Controversy. Cureus 2021; 13:e19765. [PMID: 34950544 PMCID: PMC8687795 DOI: 10.7759/cureus.19765] [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] [Accepted: 11/20/2021] [Indexed: 11/14/2022] Open
Abstract
Animal bite injuries are prevalent worldwide. Camel bites, as a cause, are relatively rare. Male camels are particularly aggressive, especially during the rutting season. These injuries, when inflicted over the face, have a disfiguration effect with possible psychological repercussions to the patient. The surgical management of facial camel bite is described sporadically and remains a source of deliberation. Our paper reports the mechanism and management of facial soft tissue injury inflicted by camel bite over the face in an adult male with long-time follow-up for the patient post surgical repair without any documented complications. This case report demonstrates the complex nature of camel bite injuries over the face. Inappropriate wound management may result in long-term sequelae, which may affect the patient’s quality of life. Individuals should apply caution when dealing with camels, mainly in the rutting season. Primary skin closure, especially to the face or neck, and proper wound management will decrease the risk of permanent scars and infections.
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Affiliation(s)
- Hany A Zaki
- Emergency Medicine, Hamad Medical Corporation, Doha, QAT
| | - Eman E Shaban
- Cardiology, Aljufairi Diagnostic and Therapeutic Hospital, Doha, QAT
| | - Ahmed E Shaban
- Internal Medicine, Mansoura General Hospital, Mansoura, EGY
| | - Haitham Hodhod
- Emergency Medicine, King's Mill Hospital, Mansfield, GBR
| | - Amr Elmoheen
- Emergency Medicine, Hamad Medical Corporation, Doha, QAT
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Abstract
ABSTRACT Camels are ungulates of the genus Camelus and have been used for centuries in parts of Asia and Africa for transport and sustenance. Handling of camels is not without its dangers, and 4 cases from South Australia are reported with a review of lethal camel-related issues. Case 1 is a 56-year-old man who died of multiple blunt force injuries after he had attempted to move a 7-year-old female dromedary (Camelus dromedarius). Case 2 is a 65-year-old woman who was crushed by 1 or more camels that she had been training. Case 3 is a 1-year-old girl who died of blunt craniocerebral trauma after the car in which she was traveling rolled when the driver swerved to avoid a herd of camels that had strayed onto the road. Case 4 is a 66-year-old woman who died of ischemic and hypertensive cardiac disease exacerbated by physical activity while rounding up camels. Deaths associated with camels involve kicking, stomping, kneeling or sitting on a victim, or biting and shaking and throwing. Lethal mechanisms include hemorrhage from vascular injuries and internal organ disruption, crush asphyxia, and blunt craniospinal injuries. Death may also follow falls from camels or vehicle collisions. Camels also carry a wide range of zoonotic diseases, the most significant of which is Middle Eastern respiratory syndrome. Handling of camels may also exacerbate underlying organic illnesses such as cardiac disease. Those working with camels should be aware that the size, strength, and temperament of these animals may make them dangerous and that they also carry potentially lethal zoonotic diseases.
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Al-Hajj S, Hammoud Z, Colnaric J, Ataya M, Macaron MM, Kadi K, Harati H, Phipps H, Mondello S, Tamim H, Abou Abbass H, Kobeissy F. Characterization of Traumatic Brain Injury Research in the Middle East and North Africa Region: A Systematic Review. Neuroepidemiology 2021; 55:1-12. [PMID: 33567436 DOI: 10.1159/000511554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/09/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Traumatic brain injury (TBI) represents a major health concern worldwide with a large impact in the Middle East and North Africa (MENA) region as a consequence of protracted wars and conflicts that adversely affect the general population. Currently, systematic TBI studies in the MENA region are lacking, nonetheless they are immensely needed to enhance trauma management and increase survival rates among TBI patients. This systematic review aims to characterize TBI in the MENA region to guide future policy choices and research efforts and inform tailored guidelines capable of improving TBI management and patient treatment and outcome. Furthermore, it will serve as a road map to evaluate and assess knowledge of trauma impact on regional health systems that can be adopted by health-care providers to raise awareness and improve trauma care. METHODS We conducted a comprehensive search strategy of several databases including MEDLINE/Ovid, PubMed, Embase, Scopus, CINAHL, Google Scholar, and the grey literature in accordance with the PROSPERO systematic review protocol CRD42017058952. Abstracts were screened, and selected eligible studies were reviewed independently by 2 reviewers. We collected demographics information along with TBI characteristics, mortality rates, and regional distribution. Data were extracted using REDCap and checked for accuracy. RESULTS The search strategy yielded 23,385 citations; 147 studies met the eligibility criteria and were included in this review. Motor vehicle accident (MVA) was the leading cause of TBI (41%) in the MENA region, followed by the military- (15.6%) and fall- (8.8%) related TBI. Males predominantly suffer from TBI-related injuries (85%), with a high prevalence of MVA- and military-related TBI injuries. The TBI mortality rate was 12.9%. The leading causes of mortality were MVA (68%), military (20.5%), and assault (2.9%). The vast majority of reported TBI severity was mild (63.1%) compared to moderate (10.7%) and severe TBI (20.2%). Patients mainly underwent a Glasgow Coma Scale assessment (22.1%), followed by computed tomography scan (8.9%) and surgery (4.1%). CONCLUSIONS Despite its clinical, social, and economic burden, the evidence of TBI research in the MENA region is scarce. Further research and high-quality epidemiological studies are urgently needed to gain a deep understanding of the TBI burden in the region, facilitate the allocation of adequate resources, implement effective preventive and intervention strategies and advise on the TBI patient management as reflective on the TBI patterns and modes.
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Affiliation(s)
- Samar Al-Hajj
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Zeinab Hammoud
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jure Colnaric
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maya Ataya
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Marie Michele Macaron
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Kamil Kadi
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hayat Harati
- Neuroscience Research Center, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | | | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussein Abou Abbass
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Neuroscience Research Center, Faculty of Medicine, Lebanese University, Beirut, Lebanon
- Department of Surgery, Makassed General Hospital, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon,
- Program for Neurotrauma, Neuroproteomics and Biomarkers Research, Departments of Emergency Medicine, Psychiatry, Neuroscience and Chemistry, University of Florida, Gainesville, Florida, USA,
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Camel Bite Associated with Depressed Skull Fracture with Rapidly Spreading Subgaleal Cellulitis. Case Rep Infect Dis 2020; 2020:8393059. [PMID: 32537256 PMCID: PMC7267871 DOI: 10.1155/2020/8393059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 02/20/2020] [Indexed: 11/22/2022] Open
Abstract
Camel bite represents a minimal proportion, and most of them are from the Middle East countries. Their infectious potential is poorly understood, and the guidelines for antimicrobial treatment are not well developed. We describe a 40-year-old male, who works as a camel herder and was bitten by a camel while he was tying it down which led to a unilateral depressed skull fracture and multiple bilateral teeth-puncture wounds in the scalp. He arrived to our emergency department 3 hours after injury. All the wounds were dry and the skin around them was healthy looking with no subcutaneous collections. CT scan of the head showed depressed skull fracture on the left temporal region. Within 12 hours, the patient developed spreading cellulitis in the scalp. This necessitated an urgent surgical intervention. The added challenge is the presence of a dural breach. Our patient presented a challenge at several levels. He presented early with clean puncture wounds that were treated according to the most agreed upon guidelines. But our novel finding of rapidly spreading cellulitis requires alteration of recommendation towards more aggressive therapeutic attitude including early surgical intervention, especially for those patients suspected of a dural tear with the depressed skull fracture, even if treated with appropriate antibiotics.
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Abstract
Camel bites are uncommon. They are more common during the rutting season where male camels become more aggressive. Herein, we report a unique case of a 25-year-old man who was repeatedly bitten to his face and neck by an aggressive camel that resulted in left eye evisceration, parotid duct, and facial nerve injury. To our knowledge, Globe rupture caused by a camel bite has not been previously reported.
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