Clinical review
Dog, cat, and human bites: A review

https://doi.org/10.1016/0190-9622(95)90296-1Get rights and content

Abstract

It is estimated that half of all Americans will be bitten by an animal or another human being during their lifetimes. The vast majority of the estimated 2 million annual mammalian bite wounds are minor, and the victims never seek medical attention. Nonetheless, bite wounds account for approximately 1% of all emergency department visits and more than $30 million in annual health care costs. Infection is the most common bite-associated complication; the relative risk is determined by the species of the inflicting animal, bite location, host factors, and local wound care. Most infections caused by mammalian bites are polymicrobial, with mixed aerobic and anaerobic species. The clinical presentation and appropriate treatment of infected bite wounds vary according to the causative organisms. Human bite wounds have long had a bad reputation for severe infection and frequent complication. However, recent data demonstrate that human bites occurring anywhere other than the hand present no more of a risk for infection than any other type of mammalian bite. The increased incidence of serious infections and complications associated with human bites to the hand warrants their consideration and management in three different categories: occlusional/simple, clenched fist injuries, and occlusional bites to the hand. This article reviews dog, cat, and human bite wounds, risk factors for complications, evaluation components, bacteriology, antimicrobial susceptibility patterns, and recommended treatments. Epidemiology, clinical presentation, and treatment of infections caused by Pasteurella multocida, Capnocytophaga canimorsus, Eikenella corrodens, and rhabdovirus (rabies only) receive particular emphasis.

References (115)

  • DJ Weber et al.

    Infections resulting from animal bites

    Infect Dis Clin North Am

    (1991)
  • EJC Goldstein et al.

    Dog bite wounds and infection: a prospective clinical study

    Ann Emerg Med

    (1980)
  • I Brook

    Bacteriologic study of paronychia in children

    Am J Surg

    (1981)
  • M Callaham

    Treatment of common dog bites: infection risk factors

    J Am Coll Emerg Physicians

    (1978)
  • RC Spencer et al.

    Routine culture of dog bites [Letter]

    Ann Emerg Med

    (1987)
  • R Edlich et al.

    Emergency department management of mammalian bites

    Emerg Med Clin

    (1986)
  • S Mahrer et al.

    Capnocytophaga canimorsus septicemia associated with cat scratch

    Pathology

    (1992)
  • PD Carpenter et al.

    DF-2 bacteremia following cat bites: report of two cases

    Am J Med

    (1987)
  • JA Scarlett et al.

    A syndrome resembling thrombocytopenic purpura associated with Capnocytophaga canimorsus septicemia

    Am J Med

    (1991)
  • L Job et al.

    Dysgonic fermenter-2: a clinico-epidemiologic review

    J Emerg Med

    (1989)
  • KD Glass

    Factors related to the resolution of treated hand infections

    J Hand Surg [Am]

    (1982)
  • EJC Goldstein et al.

    Eikenella corrodens in hand infections

    J Hand Surg [Am]

    (1983)
  • V Wahn et al.

    Horizontal transmission of HIV infection between two siblings

    Lancet

    (1986)
  • A Gravett et al.

    A trial of povidoneiodine in the prevention of infection in sutured lacerations

    Ann Emerg Med

    (1987)
  • G Groleau

    Rabies

    Emerg Med Clin North Am

    (1992)
  • RH Baevsky et al.

    Human rabies: a review

    Am J Emerg Med

    (1993)
  • EJC Goldstein

    Bite wounds and infection

    Clin Infect Dis

    (1992)
  • M Callaham

    Prophylactic antibiotics in common dog bite wounds: a controlled study

    Ann Emerg Med

    (1980)
  • J Marr et al.

    An epidemiologic study of the human bite

    Public Health Rep

    (1979)
  • LC Faulkner

    Dimensions of the pet population problem

    J Am Vet Med Assoc

    (1975)
  • AO Griffiths et al.

    Stray animals: their impact on the community

    Mod Vet Pract

    (1975)
  • EG Zook et al.

    Successful treatment protocol for canine fang injuries

    J Trauma

    (1980)
  • D Boenning et al.

    Dog bites in children: epidemilogy, microbiology, and penicillin prophylactic therapy

    Am J Emerg Med

    (1983)
  • Y Chun et al.

    Dog bites in children less than 4 years old

    Pediatrics

    (1982)
  • American College of Physicians

    Guide for adult immunization

    (1990)
  • JJ Sacks et al.

    Dog bite-related fatalities from 1979 through 1988

    JAMA

    (1989)
  • M Sands et al.

    Trimethoprim/sulfamethoxazole therapy of Pasteurella multocida infection

    J Infect Dis

    (1989)
  • ML Callaham

    Human and animal bites

    Top Emerg Med

    (1982)
  • EJC Goldstein

    Infectious complications and therapy of bite wounds

    J Am Pediatr Med Assoc

    (1989)
  • M Callaham

    Controversies in antibiotic choices for bite wounds

    Ann Emerg Med

    (1988)
  • GL Vale et al.

    Anatomic distribution of human bite marks in a series of 67 cases

    J Forensic Sci

    (1983)
  • CE Welch

    Human bite infections of the hand

    N Engl J Med

    (1936)
  • FK Boland

    Morsus humanus: sixty cases of human bites in negroes

    JAMA

    (1941)
  • D Lindsay et al.

    Natural course of the human bite wound: incidence of infection and complications in 434 bites and 803 lacerations in the same group of patients

    J Trauma

    (1987)
  • RW Malinowski et al.

    Management of human bite injuries of the hand

    J Trauma

    (1979)
  • JC Goldstein et al.

    Bacteriology of human and animal bite wounds

    J Clin Microbiol

    (1978)
  • IC Plair et al.

    Clenched fist human bite injuries

    J Hand Surg [Br]

    (1989)
  • EJC Goldstein et al.

    Bites

  • EJC Goldstein et al.

    Outpatient therapy of bite wounds: demographic data, bacteriology, and a prospective, randomized trial of amoxacillin/clavulanic acid versus penicillin ± dicloxacillin

    Int J Dermatol

    (1987)
  • I Brook

    Human and animal bite infections

    J Fam Pract

    (1989)
  • Cited by (299)

    • Animal Bites and Attacks

      2024, Emergency Medicine Clinics of North America
    • Trauma Surgery

      2023, Journal of Oral and Maxillofacial Surgery
    • Outcome of human amniotic membrane wrap around neurorrhaphy in high radial nerve injury - a case report following monkey bite

      2022, Injury
      Citation Excerpt :

      Animal bite injuries are commonly seen in emergency departments and are known for their infectious potential. Monkey bites are an important risk among travelers, second only to dog bites [1]. Multiple factors contribute to high mortality and morbidity due to animal bites.

    • Animal bite wounds and their management in tropical Australia

      2022, International Journal of Infectious Diseases
    View all citing articles on Scopus

    Reprints not available from the authors.

    View full text