Lim Jung Soo, Byun Jin Hwan, Min Kyung Hee, Lee Hye Kyung, Choi Yun Sun
Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
Department of Radiology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
Arch Plast Surg. 2016 Nov;43(6):590-594. doi: 10.5999/aps.2016.43.6.590. Epub 2016 Nov 18.
Recently, the number of cases of animal bite wounds has increased significantly in concordance with an increase in the pet population around the world. The authors report two rare cases of osteomyelitis of the phalanx following cat and dog bites. On initial physical examination, signs of a severe infection were observed. Radiographs of both patients showed the presence of osteomyelitis, and in one of the patients, the diagnosis was confirmed with a bone biopsy. After use of empirical antibiotics, intravenous antibiotic therapy that matched the identified bacterium's sensitivity was initiated, and at the same time, secure dressing including debridement was performed to induce secondary healing. In addition, the patients were closely monitored with serial X-rays, and culture and blood test follow-up. One patient fully recovered without sequelae, but the other patient suffered a loss of distal interphalangeal joint motion. When dealing with bite wounds located on the hand, it is important to visit the hospital as soon as possible and receive the appropriate treatment early. Moreover, to prevent severe complications such as osteomyelitis, it is important to administer antibiotic therapy to which the cultured bacteria are sensitive, along with proper wound management and prophylactic antibiotic treatment.
近年来,随着全球宠物数量的增加,动物咬伤伤口的病例数显著上升。作者报告了两例猫和狗咬伤后指骨骨髓炎的罕见病例。初次体格检查时,发现了严重感染的迹象。两位患者的X线片均显示存在骨髓炎,其中一位患者通过骨活检确诊。在使用经验性抗生素后,开始了与鉴定出的细菌敏感性相匹配的静脉抗生素治疗,同时进行了包括清创在内的妥善包扎以促进二期愈合。此外,通过连续X线检查、培养和血液检查随访对患者进行密切监测。一位患者完全康复且无后遗症,但另一位患者远侧指间关节活动丧失。处理手部咬伤伤口时,尽早就诊并尽早接受适当治疗非常重要。此外,为预防骨髓炎等严重并发症,使用对培养出的细菌敏感的抗生素治疗,同时进行适当的伤口处理和预防性抗生素治疗也很重要。