Review article
Microbiology and management of human and animal bite wound infections

https://doi.org/10.1016/S0095-4543(02)00056-8Get rights and content

Section snippets

Microbiology

A variety of organisms that generally result from the aerobic and anaerobic microbial flora of the oral cavity of the biting animal, rather than the victim's own skin flora, can be recovered from bite wounds. Most infections are polymicrobial. The role of anaerobes in bite wound infections has been increasingly appreciated [8], [9], [10], [11], [12]. Anaerobes have been isolated from more than two thirds of human and animal bite wound infections, especially those associated with abscess

Pathogenesis

The potential for infection of human or animal bites is great. For example, a dog's teeth are not sharp but can exert a pressure of 200 to 450 psi [59]. This pressure is strong enough to perforate sheet metal and result in a crush injury with much devitalized tissue, rather than a laceration. The average dog mouth harbors more than 64 species of bacteria, including S. aureus, P. multocida, anaerobic bacteria (especially of the pigmented Prevotella and Porphynomonas sp) and CDC types IIj (

Diagnosis

The symptoms occurring after a bite depend on the animal species inflicting the injury. Immediate local or systemic symptoms can be severe after venomous animals (snake, lizard, spider, and so forth). Human or dog bites generally do not cause immediate symptoms different from those of a laceration injury. Because of the direct introduction of oral and skin flora into the wound, however, if an infection occurs, it develops quite rapidly. The signs of infection can include redness, swelling, and

Management

Wound management includes the administration of proper local care and the utilization, when needed, of proper antimicrobial agents. Evaluation and wound care for bites include recording medical history (animal involved, provoked or unprovoked attack, current medications, splenectomy, mastectomy, allergies, chronic disease, and immunosuppression); examining the wound and related structures (odor of exudates, depth, type, and location of wound, range of motion, joint involvement, edema or crush

Complications

Hand wounds present a special problem, because 30% or more become infected [59], [61]. Because of the presence of avascular tendon and sheath spaces, the propensity for spread of infection, and disastrous results of such infection on function, the threat of complications after bite wounds must be addressed. In addition to local wound infection, other complications include lymphangitis, local abscess, septic arthritis, tenosynovitis, and osteomyelitis [33], [67]. Rare complications include

First page preview

First page preview
Click to open first page preview

References (79)

  • P.S Auerbach et al.

    Bacteriology of the marine environment: implications for clinical therapy

    Ann Emerg Med

    (1987)
  • M Callaham

    Treatment of common dog bites: infection risk factors

    JACEP

    (1978)
  • P.D Carpenter et al.

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

    Am J Med

    (1987)
  • M Garre et al.

    Fulminant Eubacterium plautii infection following dog bite in asplenic man

    Lancet

    (1991)
  • R Kalb et al.

    Cutaneous infection at dog bite wounds associated with fulminant DF-2 septicemia

    Am J Med

    (1985)
  • J.R Galvin et al.

    Infection rate of simple suturing

    JACEP

    (1976)
  • D.M Klein et al.

    Pasteurella multocida brain abscess following perforating cranial dog bite

    J Pediatr

    (1978)
  • L.F McCaig

    National Hospital Ambulatory Medical Care Survey: 1998 emergency department summary

    Adv Data

    (2000)
  • C.B Farmer et al.

    Human bite infections of the hand

    South Med J

    (1966)
  • H.G Thomson et al.

    Small animal bites: the role of primary closure

    J Trauma

    (1973)
  • E.J.C Goldstein et al.

    Monkey bites and infection

    Clin Infect Dis

    (1995)
  • E.J.C Goldstein

    New horizons in the bacteriology, antimicrobial susceptibility and therapy of animal bite wounds

    J Med Microbiol

    (1998)
  • E.J.C Goldstein et al.

    Role of anaerobic bacteria in bite wound infections

    Rev Infect Dis

    (1984)
  • C.J Alexander et al.

    Characterization of saccharolytic Bacteroides and Prevotella isolates from infected dog and cat bite wounds in humans

    J Clin Microbiol

    (1997)
  • D.M Citron et al.

    Frequency of isolation of Porphyronionas species from infected dog and cat bite wounds in humans and their characterization by biochemical tests and AP-PCR fingerprinting

    Clin Infect Dis

    (1996)
  • E.J.C Goldstein et al.

    Emergency Medicine Animal Bite Infection Study Group. Prevalence and characterization of anaerobic bacteria from 50 patients with infected cat and dog bite wounds

  • D.J Weber et al.

    Pasteurella multocida infections: report of 34 cases and review of the literature

    Medicine (Baltimore)

    (1984)
  • E Holst et al.

    Characterization and distribution of Pasteurella species recovered from infected humans

    J Clin Microbiol

    (1992)
  • D.J Brenner et al.

    Capnocytophaga canimorsus sp. nov. (formerly CDC group DF-2), a cause of septicemia following dog bite, and C. cynodegmi sp. nov., a cause of localized wound infection following dog bite

    J Clin Microbiol

    (1989)
  • D.R Graham et al.

    Infections caused by Moraxella, Moraxella urethralis, Moraxella-like groups M-5 and M-6, and Kingella kingae in the United States, 1953–1980

    Rev Infect Dis

    (1990)
  • B.M Andersen et al.

    Neisseria weaveri sp. nov., formerly CDC group M-5, a gram-negative bacterium associated with dog bite wounds

    J Clin Microbiol

    (1993)
  • J Reina et al.

    Leg abscess caused by Weeksella zoohelcum following a dog bite

    Clin Infect Dis

    (1992)
  • M Guidourdenche et al.

    Isolation of Neisseria canis in mixed culture from a patient after a cat bite

    J Clin Microbiol

    (1989)
  • D.G Hollis et al.

    Characterization of Centers for Disease Control group NO-1, a fastidious, nonoxidative, gram-negative organism associated with dog and cat bites

    J Clin Microbiol

    (1993)
  • C.W Moss et al.

    Cultural and chemical characterization of CDC groups EO-2, M-5 and M-6, Moraxella (Moraxella) species, Oligella urethralis, Acinetobacter species and Psychrobacter immobilis

    J clin Microbiol

    (1988)
  • E.J.C Goldstein et al.

    Recovery of an unusual Flavobacterium group IIb-like isolate from a hand infection following pig bite

    J Clin Microbiol

    (1990)
  • M.M Peel et al.

    Actinobacillus spp. and related bacteria in infected wounds of humans bitten by horses and sheep

    J Clin Microbiol

    (1991)
  • D.K Murphey et al.

    Catfish-related injury and infection: report of two cases and review of the literature

    Clin Infect Dis

    (1992)
  • J Capellan et al.

    Tularemia from a cat bite: case report and review of feline-associated tularemia

    Clin Infect Dis

    (1993)
  • Cited by (0)

    View full text