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Bite
Classification and external resources

A dog exhibiting his teeth.
ICD-10 T14.1
ICD-9 E906.5
MeSH D001733

A bite is a wound received from the mouth (and in particular, the teeth) of an animal, including humans. Animals may bite in self-defense, in an attempt to predate food, as well as part of normal interactions. Other bite attacks may be apparently unprovoked. Self inflicted bites occur in some genetic illnesses such as Lesch-Nyhan syndrome.

Biting is an act that occurs when an animal uses its teeth to pierce another object, including food, flesh and inanimate matter.

Contents

Classification

Bites are usually classified by the type of creature causing the wound. Many different creatures are known to bite humans.

  • Flea bites are responsible for the transmission of bubonic plague.
  • Mosquito bites are responsible for the transmission of malaria.
  • The bites of various mammals such as bats, rabbits, wolves, raccoons, etc. may transmit rabies.
  • Infections other than rabies are also common from bite wounds

Rabies is a deadly disease.

Signs and symptoms

Bite wounds raise a number of medical concerns for the physician or first aider including:

Animal Bites

A common misconception is that the Tasmanian Devil has the strongest animal bite, when in fact it is second behind a Crocodile. The bite of a Tasmanian Devil measures up to 2124 PSI.

Human bites

Injuries from human bites, present a particular risk to other humans, with a major risk of sepsis from infection by human oral bacteria and the possibility of transmission of blood-borne diseases including, syphilis and hepatitis.

Involuntary biting injuries due to closed-fist injuries from fists striking teeth (referred to as reverse bite injuries) are a common consequence of fist fights. These have been termed "fight bites". Injuries in which the knuckle joints or tendons of the hand are bitten into tend to be the most serious.

In spite of their name, love bites are not biting injuries (they involve bruising from sucking, and the skin is not broken), although actual biting injuries are sometimes seen as the result of fetishistic activities.

Treatment

Bite wounds should be cleaned and debrided as necessary but not closed. Ampicillin/sulbactam is indicated as HACEK endocarditis is the most worrying complication. A punctate wound over a joint surface should be regarded as an open joint injury until proven otherwise.

Treatment

Bite wounds are washed, ideally with povidone-iodine soap and water. The injury is then loosely bandaged, but is not sutured due to risk of infection.

Antibiotics

Antibiotics prophylaxis is recommended for dog and cat bites of the hand[1] and human bites if they are more than superficial.[2] Evidence for the need for antibiotic prophylaxis for bites in other areas inconclusive.[3]

For empirical therapy, the first choice is amoxicillin with clavulanic acid, and if the person is penicillin allergy doxycycline and metronidazole.[2] The anti-staphylococcal penicillins (e.g., cloxacillin, nafcillin, flucloxacillin) and the macrolides (e.g., erythromycin, clarithromycin) are not used for empirical therapy, because they do not cover Pasteurella species.[2]

Rabies

Animal bites inflicted by some animals, including carnivorans and bats can transmit rabies. The animal is caught alive or dead with its head preserved, so the head can later be analyzed to detect the disease. Signs of rabies include foaming at the mouth, self-mutilation, growling, jerky behavior, and red eyes. If the animal lives for ten days and does not develop rabies, then it is probable that no infection has occurred.

If the animal cannot be captured, prophylactic rabies treatment is recommended in most places. Certain places, such as Hawaii, Australia and the United Kingdom, are known not to have native rabies. Treatment is generally available in North America and the Northern European states.

Tetanus

Tetanus toxoid is indicated for virtually any bite that punctures the epidermis and tetanus immune globulin is indicated in patients with more than 10 years since prior vaccination. Tetanus boosters (Td) should be given every ten years.

Prior toxoid Clean minor wounds All other wounds
<3 doses TT: yes, TIG: no TT: yes, TIG: yes
≥3 doses TT: if last dose ≥ 10yr
TIG: no
TT: if last dose ≥ 5yr, TIG: no

TT = Tetanus Toxoid; TIG: Tetanus Immune globulin

Mosquito bites

Antihistamines are effective treatment for the symptoms from bites.[4] Many diseases such as malaria are transmitted by mosquitoes.

Behavior

Biting is an age appropriate behavior and reaction for children 2.5 years and younger. Conversely children above this age have verbal skills to explain their needs and dislikes and biting is not age appropriate. Biting may be prevented by methods including redirection, changing the environment and responding to biting by talking about appropriate ways to express anger and frustration. School age children, those older than 2.5 years, who habitually bite may require professional help. [5]

Biting is also a behavior found in many adult animals (including humans), often as part of sexual petting. Some discussion of human biting appears in The Kinsey Report on Sexual Behavior in the Human Female.

See also

References

  1. ^ "BestBets: Antibiotics in cat bites". http://www.bestbets.org/bets/bet.php?id=1021. 
  2. ^ a b c Oehler RL, Velez AP, Mizrachi M, Lamarche J, Gompf S (2009). "Bite-related and septic syndrome caused by cats and dogs". Lancet Infect Dis 9: 439–47. 
  3. ^ Medeiros I, Saconato H (2001). "Antibiotic prophylaxis for mammalian bites". Cochrane Database Syst Rev (2): CD001738. doi:10.1002/14651858.CD001738. PMID 11406003. 
  4. ^ "BestBets: Oral antihistamines for insect bites". http://www.bestbets.org/bets/bet.php?id=1074. 
  5. ^ Child Care Links, "How to Handle Biting", retrieved 14 August 2007

External links


Simple English

A bite is a wound received from the teeth of an animal. Animals may bite things in self-defence. Animals also bite things to cut them into smaller pieces before they eat them.

Bites can cause many medical problems, such as:

Treatment

Bite wounds should be washed, ideally with povidone-iodine soap and water. The injury should then be loosely wrapped with a bandage. Open bite wounds are not sutured because of the risk of infection.

Animal bites caused by carnivores (other than rodents) may infect the victim with rabies if the animal that bit them carries it. If possible, the animal is caught and the head is looked at for signs of rabies. Signs of rabies include foaming at the mouth, self-mutilation, growling, jerky behaviour, and red eyes. If the animal lives for ten days and does not develop rabies, then the animal probably is not infected. In cases where the animal cannot be found, prophylactic rabies treatment is carried out in most places.

Snake bites

Many of the world's snakes are not considered dangerous to humans, but even a bite from a "safe" snake may injure the victim if the wound is not treated properly, and large snakes such as constrictors are capable of causing a lot of damage with their bites.

Spider bites

The black widow spider and some scorpions are considered dangerous to humans, mostly to small children and elderly adults. Only the Sydney funnel-web spider of Australia is frequently dangerous to adults, and it lives only within 100 miles of Sydney. Antivenins are available in the United States for black widow spiders and the dangerous scorpions native to the region.








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