Bite

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Bite
Classification and external resources

Military working dog training to attack by biting.
ICD-10T14.1
ICD-9E906.5
MedlinePlus000034
MeSHD001733
 
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Bite
Classification and external resources

Military working dog training to attack by biting.
ICD-10T14.1
ICD-9E906.5
MedlinePlus000034
MeSHD001733

A bite is a wound received from the mouth (and in particular, the teeth) of an animal, including humans. Animals may bite in self-defense, in an attempt to predate food, as well as part of normal interactions. Other bite attacks may be apparently unprovoked. Self-inflicted bites occur in some genetic illnesses such as Lesch-Nyhan syndrome. Biting is an act that occurs when an animal uses its teeth to pierce another object, including food, flesh and inanimate matter. A person bitten by an animal potentially carrying parvovirus or rabies virus should consult a medical doctor immediately. An animal bite victim may also incur serious bacterial infections of the bone called osteomyelitis which can become life threatening if untreated, whether or not the animal has parvovirus or rabies virus.

Contents

Classification

A mosquito bite

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

Arthropods

Vertebrates other than humans

Involuntary biting injuries due to closed-fist injuries from fists striking teeth (referred to as reverse bite injuries) are a common consequence of fist fights. These have been termed "fight bites". Injuries in which the knuckle joints or tendons of the hand are bitten into tend to be the most serious.

In spite of their name, love bites are not biting injuries (they involve bruising from sucking, and the skin is not broken), although actual biting injuries are sometimes seen as the result of fetishistic activities.

Other

Signs and symptoms

Bite wounds raise a number of medical concerns for the physician or first aider including:

Treatment

Bite wounds should be cleaned and debrided as necessary but not closed. Ampicillin/sulbactam is indicated as HACEK endocarditis, specifically Eikenella, is the most worrying complication. A punctate wound over a joint surface should be regarded as an open joint injury until proven otherwise.

Treatment

Bite wounds are washed, ideally with povidone-iodine soap and water. The injury is then loosely bandaged, but is not sutured due to risk of infection.

Antibiotics

Antibiotics prophylaxis is recommended for dog and cat bites of the hand[3] and human bites if they are more than superficial.[4] Evidence for the need for antibiotic prophylaxis for bites in other areas inconclusive.[5]

For empirical therapy, the first choice is amoxicillin with clavulanic acid, and if the person is penicillin allergy doxycycline and metronidazole.[4] The anti-staphylococcal penicillins (e.g., cloxacillin, nafcillin, flucloxacillin) and the macrolides (e.g., erythromycin, clarithromycin) are not used for empirical therapy, because they do not cover Pasteurella species.[4]

Rabies

Animal bites inflicted by some animals, including carnivorans and bats can transmit rabies. The animal is caught alive or dead with its head preserved, so the head can later be analyzed to detect the disease. Signs of rabies include foaming at the mouth, self-mutilation, growling, jerky behavior, and red eyes.

If the animal cannot be captured, prophylactic rabies treatment is recommended in most places. Certain places, such as Hawaii, Australia and the United Kingdom, are known not to have native rabies. Treatment is generally available in North America and the Northern European states.

Tetanus

Tetanus toxoid is indicated for virtually any bite that punctures the epidermis and tetanus immune globulin is indicated in patients with more than 10 years since prior vaccination. Tetanus boosters (Td) should be given every ten years.

Prior toxoidClean minor woundsAll other wounds
<3 dosesTT: yes, TIG: noTT: yes, TIG: yes
≥3 dosesTT: if last dose ≥ 10yr
TIG: no
TT: if last dose ≥ 5yr, TIG: no

TT = Tetanus Toxoid; TIG: Tetanus Immune globulin

Mosquito bites

Antihistamines are effective treatment for the symptoms from bites.[6] Many diseases such as malaria are transmitted by mosquitoes.

See also

References

  1. ^ Kenneth M. Phillips (2009-12-27). "Dog Bite Statistics". http://www.dogbitelaw.com/PAGES/statistics.html. Retrieved 2010-08-06. 
  2. ^ Questions and Answers about Dog Bites
  3. ^ "BestBets: Antibiotics in cat bites". http://www.bestbets.org/bets/bet.php?id=1021. 
  4. ^ a b c Oehler RL, Velez AP, Mizrachi M, Lamarche J, Gompf S (2009). "Bite-related and septic syndrome caused by cats and dogs". Lancet Infect Dis 9 (7): 439–47. doi:10.1016/S1473-3099(09)70110-0. PMID 19555903. 
  5. ^ Medeiros I, Saconato H (2001). Medeiros, Iara Marques. ed. "Antibiotic prophylaxis for mammalian bites". Cochrane Database Syst Rev (2): CD001738. doi:10.1002/14651858.CD001738. PMID 11406003. 
  6. ^ "BestBets: Oral antihistamines for insect bites". http://www.bestbets.org/bets/bet.php?id=1074. 

External links