Human and Other Mammalian Bite Injuries of the Hand

Abstract

The hand is the most common site for bite injuries. Because of specific characteristics of hand anatomy, bite mechanics, and organisms found in human and animal saliva, even small wounds can lead to aggressive infections. Failure to recognize and treat hand bites can result in significant morbidity. Human and animal bites most commonly lead to polymicrobial bacterial infections with a mixture of aerobic and anaerobic organisms. Pasteurella species are commonly found in dog and cat bite wounds, and Eikenella is characteristic of human wounds. Staphylococcus, Streptococcus, and anaerobic bacterial species are common to all mammals. Although public health measures in developed countries have been highly effective at reducing rabies transmission, dog bites remain the most common source of rabies infection worldwide. Human bites can transmit HIV, hepatitis B, or hepatitis C, especially when contaminated blood is exposed to an open wound. Appropriate management of any mammal bite requires recognition, early wound cleansing, evaluation of injured structures, and infection prophylaxis. Structural repair is performed as indicated by the severity and contamination of the injury, and wounds may require delayed closure. Wound infections typically require débridement, empiric antibiotics, and delayed repair or reconstruction.

Early complications of human bites to the hand in HIV-positive patients

“…3,7,8 The most common type of human bite injury to the hand has previously been reported to be fight bites. [3][4][5] This was not our experience as 67% of cases involved the occlusive type of bite injuries. Delay in presentation has been documented extensively in the literature as the single most important determinant of morbidity following human bites to the hand.…”

“…Irrespective of the mechanism, they are associated with a high complication rate and this has been attributed to the unique anatomy of the hand and the pathogens involved in human bites. 3,4 In addition, wounds are generally small in size resulting in a casual approach to their management. About a third of patients who present with a human bite injury to the hand may present a different cause of their injury rather than a human bite and thus it is important to have a high index of suspicion when viewing injuries over the dorsal area of the metacarpals.…”

“…About a third of patients who present with a human bite injury to the hand may present a different cause of their injury rather than a human bite and thus it is important to have a high index of suspicion when viewing injuries over the dorsal area of the metacarpals. [3][4][5] Complications of a human bite include cellulitis, septic arthritis, tenosynovitis, hand stiffness, lymphangitis and osteomyelitis. 4,6,7 Certain developing regions have been experiencing a growing level of social and interpersonal violence.…”

“…[3][4][5] Complications of a human bite include cellulitis, septic arthritis, tenosynovitis, hand stiffness, lymphangitis and osteomyelitis. 4,6,7 Certain developing regions have been experiencing a growing level of social and interpersonal violence. 8 As a result, human bites to the hand have also been encountered more frequently.…”

Pyogenic Arthritis of the Metacarpophalangeal Joint Treated with External Fixation in Adolescent

“…Hand injuries caused by human bites are seen relatively often in clinical practice 1 . The majority of patients with human bites visit the hospital a considerable time after the injury.…”