Gasser I, Osset J, Olarte I, Olsina M, Arcalís L
Servicio de Microbiología y Parasitología, Ciudad Sanitaria y Universitaria Vall d'Hebron, Barcelona.
Enferm Infecc Microbiol Clin. 1993 Nov;11(9):482-6.
To study the characteristics of bite wounds with unfavorable evolution, developing infectious complications that requires hospital admission.
The data from 22 patients admitted to the Ciudad Sanitaria Vall d'Hebron hospital for the above mentioned reason over the last 5 years were reviewed.
The patients (8 males, 8 females and 6 children) were bitten by 10 dogs, 6 cats, and 6 men with predominance of the wound site being in the upper limb (10) followed by the lower limbs (6), head or face (5) and exceptionally on the breast (1). The most frequent clinical manifestation was abscess and/or cellulitis (13) and adenopathies or lymphangitis (4); 5 patients presented osteoarticular involvement including 3 bone fractures due to human aggression. With regard to the etiology of infection, the common bucal flora bacteria were isolated in all the cases; Pasteurella multocida in 15/16 animal bites, Eikenella corrodens associated to streptococcus in 5/6 human bites, Fusobacterium spp. (5), Bacteroides spp. (3) and Peptococcus sp. (1). The most frequently administered antibiotics were gentamycin (15), penicillin (13), cloxacillin (5) and clindamycin (4). The evolution was favorable, although slow in many cases, with sequelae in 3 patients.
It is very difficult to foresee in which cases infectious complications will develop in bite wounds. According to the authors' experience, in the case of deep wounds the bacteria implied come from the mouth of the aggressor. Careful cleansing, rapid administration of an adequate antibiotic and clinical control being the most recommendable procedure.
