Animal Bites: A Board Review Short

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"pusy discharge?"

mike p. -

I don't know how "right" it is but our hand surgeons for bites to the hand always have us irrigate the hell out of it and given IV zosyn almost EVERY TIME. Not really expensive, but time consuming in the ED. Thoughts? Does this really make a difference than just proper PO coverage and irrigation.

Kevin S. -

There was no discussion of Captocytophaga canimorsus from dogs/cats which can cause severe sepsis. I saw a patient who was bitten by a dog on the finger and presented with fever, chills and flu like symptoms. He didn't tell me the injury was from a dog, but instead chose to tell me it was from a broken wine glass in order to protect the dog. The finger didn't look infected, but he rapidly deteriorated overnight with multiorgan failure and fulminant sepsis the next day. Usually only affects immunocompromised patients but mine was not. Other literature reports similar cases from bites and some from even dogs licking open wounds!

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