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Animal bite infection in Child
Other Resources UpToDate PubMed

Animal bite infection in Child

Contributors: Eric Ingerowski MD, FAAP, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Animal bites to pediatric patients account for 1% of all visits to emergency rooms and urgent care centers. Most animal bites are caused by domesticated animals, with dog bites accounting for over 90% of cases, followed by cat bites at 8%. Human bites and other animals account for less than 2% of cases. In younger children, the face, neck, and head are most frequently involved, while the extremities are more often involved in older children. Most animal bites are unprovoked and occur during the spring and summer months by an animal that lives at the victim's residence. Infection is a frequent complication of animal bites, occurring in up to 50% of cat bites and 5%-15% of dog bites. While nontraditional pets and wild animals account for a small minority of pediatric animal bites, they may carry unique and significant infectious risks.

Infections secondary to animal bites include bacterial and viral etiologies. Factors that increase the risk of bacterial infection include crush injuries or puncture-like wounds (frequent with cats), a bite involving the hands or feet, an immunocompromised host (including diabetes), and preexisting impaired blood flow or lymphatic drainage to the bite area. A delay in seeking medical care (more than 12 hours for bites to the extremities or more than 24 hours for those to the head / neck), or improper initial bite management, is also associated with increased risk of infection.

Typical symptoms of an animal bite infection include pain, skin redness, warmth, swelling, and possibly purulent discharge. Lymphangitis, tissue abscess, or cellulitis may also be present. In more severe cases, regional adenopathy and fevers may develop. Tenosynovitis, septic arthritis, pyomyositis, and osteomyelitis may also occur in more severe cases.

The typical bacterial organisms involved are related to the offending animal's oral flora or skin flora from the victim. These include Streptococcus spp, Staphylococcus spp, Eikenella spp, Pasteurella multocida, Pasteurella spp, Bacteroides spp, and oral anaerobes. Most infections involve a mix of aerobic and anerobic bacteria. Proper treatment with aggressive wound debridement, irrigation, and antimicrobial therapy is essential. Other notable infections include cat scratch (bite) fever and viral infections such as rabies.

Codes

ICD10CM:
W55.81XA – Bitten by other mammals, initial encounter

SNOMEDCT:
399907009 – Animal bite wound

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Last Reviewed:05/31/2021
Last Updated:06/06/2021
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Animal bite infection in Child
Animal bite infection : Fever, Lymphangitis, Regional lymphadenopathy, Wound
Clinical image of Animal bite infection
Pasteurella multocida infection; 24 hours post cat bite.
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