Pathogens

Streptococci

Staphylococci

Fusobacterium spp.

Eikenella corrodens

Evaluation

Record mechanism of injury (such as closed fist)

Assess location, depth, size, and type of wound

Evidence of infection, including redness, lymph node involvement, discharge

Factors indicating a high-risk bite wound include location (on hands, genitalia, or near joints), puncture or crush wounds vs lacerations, and compromised immune status

Management

Moderate to severe wounds, presence of infection, and/or other high-risk factors warrant medicine consultation

Management includes copious irrigation, topical antimicrobial, dressing as indicated, wound elevation, tetanus booster (if not administered in the last 5 years), pain management, and suturing for facial wounds

Studies may include cultures from visibly infected wounds and x-rays to rule out fracture, foreign body, and/or joint space involvement.

Antimicrobial treatment is indicated for evidence of infection and prophylaxis of high-risk bite wounds and may include amoxicillin/clavulanate 875 mg/125 mg p.o. BID for 3-5 d for uninfected wounds

Infected wounds/bone and/or joint involvement require intravenous therapy and medicine consultation