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Source: Fish DN. Skin and soft-tissue infections. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146071658. Accessed March 23, 2017.
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Animal bite.
Dogs: Most infections polymicrobial; most frequently isolated organisms Pasteurella spp., streptococci, staphylococci, Moraxella, and Neisseria. Most common anaerobes Fusobacterium spp., Bacteroides spp., Porphyromonas, and Prevotella.
Cats: Infections frequently caused by Pasteurella multocida.
Human bite.
Most often caused by normal oral flora, including both aerobic (Streptococcus spp., Staphylococcus spp., and Eikenella corrodens) and anaerobic (Fusobacterium, Prevotella, Porphyromonas, and Peptostreptococcus spp.) microorganisms.
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Animal bite.
High risk of infection owing to pressure exerted during bite and large number of potential pathogens.
Cat bites: higher incidence of septic arthritis and osteomyelitis.
Dog bites: crush injuries with much devitalized tissue.
Human bite.
More serious and prone to infection than animal bites.
Hand (most common): Force of punch to mouth causes breach in capsule of metacarpophalangeal joint, leading to direct inoculation of bacteria into joint or bone.
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CLINICAL PRESENTATION
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Animal bite: Patient generally presents either immediately after bite for general wound care or >12 hours after injury due to clinical signs of infection.
Human bite: Most clenched-fist injuries are infected by time patients seek medical care and require hospitalization.
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All bites:
Animal bite:
Human bite:
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MEANS OF CONFIRMATION AND DIAGNOSIS
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Culture for aerobic and anaerobic bacteria; not needed if <8 hours or >24 hours elapsed since bite and no signs of infection.
White blood counts should be monitored for resolution of infection if initially elevated.
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