Animal and Human Bites

Did you know that there are an estimated 5 million human or animal bite wounds occur annually in the United States? Dog bite wounds are the most common, and infections rates can be as high as 50% for cat bite wounds. Today, pediatric resident, Dr. Jack Noel, joins pediatric emergency medicine physician, Dr. Jim Wilde, and pediatric emergency medicine fellow, Dr. Inna Kaminecki, to explore the common management strategies and potential pitfalls to avoid.

Specifically, we will be covering the following:
1. Recognize common history and physical exam findings associated with animal and human bites.
2. Be able to recognize important pathogenic bacteria associated with animal and human bites. 
3. Understand the initial diagnostic approach to animal and human bites.
4. Initiate appropriate prophylaxis in animal and human bites to prevent tetanus, rabies, and wound infection. 
5. Initiate appropriate management of bite wounds. 
6. Create an appropriate disposition for patient with bite wounds.

FREE CME Credit (requires sign-in):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11167 

Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia. If you have any comments, suggestions, or feedback- you can email us at mcgpediatricpodcast@augusta.edu

Remember that all content during this episode is intended for educational purposes only. It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenarios. Thank you for your support!

References:
1. Bula-Rudas FJ, Olcott JL. Human and Animal Bites. Pediatr Rev. 2018 Oct;39(10):490-500. 
2. Edens MA, Michel JA, Jones N. Mammalian Bites In The Emergency Department: Recommendations For Wound Closure, Antibiotics, And Postexposure Prophylaxis. Emerg Med Pract. 2016 Apr;18(4):1-20. 
3. Centers for Disease Control and Prevention (CDC). Nonfatal dog bite-related injuries treated in hospital emergency departments-United States, 2001. MMWR Morb Mortal Wkly Rep. 2003 Jul 4;52(26):605-610. 
4. Liang JL, Tiwari T, Moro P, Messonnier NE, Reingold A, Sawyer M, Clark TA. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2018 Apr 27;67(2):1-44. 
5. Havers FP, Moro PL, Hunter P, Hariri S, Bernstein H. Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020 Jan 24;69(3):77-83.
6.  American Academy of Pediatrics. Bite wounds. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018-2021 Report of the Committee on Infectious Diseases. 31st ed. Elk Grove Village, IL: American Academy of Pediatrics; 2018:189–195. 
7. American Academy of Pediatrics. Rabies. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018-2021 Report of the Committee on Infectious Diseases. 31st ed. Elk Grove Village, IL: American Academy of Pediatrics; 2018:673-680.
8. American Academy of Pediatrics. Tetanus. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018-2021 Report of the Committee on Infectious Diseases. 31st ed. Elk Grove Village, IL: American Academy of Pediatrics; 2018:793-798.
9. S. Ramgopal, M.L. Macy, US estimates for dog bite injuries presenting to emergency departments, Public Health, Volume 196, 2021,Pages 1-3, ISSN 0033-3506 https://doi.org/10.1016/j.puhe.2021.04.028.