The
article was prompted by the authors' experience in treating an elderly man who
developed a progressive infection of the hand after being bitten on the finger
by an opossum. The patient recovered after hospitalization including treatment
with intravenous antibiotics.
Dr.
Rao and colleagues performed a research review to identify studies of rare
animal bites and stings. While many reports have discussed treatment of dog,
cat, and snake bites, there has been no recent, comprehensive review focusing
on the recommended treatment and potential adverse effects of less-common types
of animal bites and injuries.
The
review identified 71 articles, including a total of 214 patients, describing
less frequently seen bite and sting injuries of the upper limb (hand and arm).
Most of the studies were case reports and patient series
Aquatic
animals were by far the most commonly reported type of injury, accounting for
two-thirds of studies. Stings from jellyfish, lionfish and sea anemones, as
well as other venomous aquatic animals, can not only cause severe pain and
swelling but may sometimes lead to severe or even life-threatening
complications.
Ten
percent of studies reported bites by reptiles. Bites by some of these animals,
such as beaded lizards, can cause envenomation leading to systemic shock.
Other
reports described serious complications resulting from bites caused by small
mammals and rodents such as ferrets, skunks, and squirrels. Other categories,
including just a few cases each, included serious injuries caused by large
mammals, scorpions and centipedes and birds.
The
studies suggested that most infections resulting from animal bites are
"polymicrobial," caused by several different bacteria or other germs.
Infections with multiple, often unfamiliar microbes have the potential to cause
tissue destruction and systemic (body-wide) reactions.
Based
on the available evidence, Dr. Rao and colleagues outline quick reference
principles for the treatment of wild animal bites and stings. These include
specific recommendations for preventive antibiotics, providing coverage for
unusual bacteria that may be present in infected wounds.
See:
Posted by Dr. Tim Sandle
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