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MAMMALIAN BITES

  • Each year, there are ~300 dog and cat bites per 100,000 population in the United States, with most bites inflicted by pet animals.

  • The microbiology of bite wounds typically reflects the oral flora of the biting animal.

  • Bites from many different animals can transmit rabies and tularemia.

DOG BITES

  • Epidemiology: Dogs bite ≥4.7 million people per year, causing 80% of all animal bites; 15–20% of dog bites become infected.

  • Bacteriology (Table 27-1): includes aerobic and anaerobic organisms, such as β-hemolytic streptococci; Eikenella corrodens; Capnocytophaga canimorsus; and Pasteurella, Staphylococcus, Actinomyces, and Fusobacterium species

  • Clinical features: typically manifest within 8–24 h after the bite as local cellulitis with purulent, sometimes foul-smelling discharge. Systemic spread (e.g., bacteremia, endocarditis, brain abscess) can occur. C. canimorsus infection can present as sepsis syndrome, DIC, and renal failure, particularly in pts who are splenectomized, have hepatic dysfunction, or are otherwise immunosuppressed.

TABLE 27-1MANAGEMENT OF WOUND INFECTIONS FOLLOWING ANIMAL AND HUMAN BITES

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