Bite Wound

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍catdoghumanrodent bite wound that occurred ‍ ‍days ago

Location is on ‍rightleft ‍ ‍hand

Mechanism: ‍, ‍unprovokedprovoked

Alleviating factors: ‍none, ‍effectiveineffective

Occupation: ‍

Work-related injury: ‍yesno



Associated symptoms: *Try using right-click for negatives*

‍pain

‍redness

‍swelling

‍discharge

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍difficulty moving the affected area



Contributing factors:

no history of: ‍diabetes, ‍immunodeficiency

no use of: ‍anticoagulants



Tetanus vaccination: ‍up-to-dateincompleteunvaccinated





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Skin: ‍rashlesions on ‍





ASSESSMENT:

Bite wound from ‍dog, ‍infectednot infected ‍likelysuspectedpossible

DDx: cellulitis, abscess, tetanus, rabies, retained foreign body (tooth), fracture, osteomyelitis, septic arthritis, infectious tenosynovitis, lymphangitis, compartment syndrome





PLAN:

Investigations:

- Wound culture

- X-ray if bone injury or foreign body suspected

- Blood work: ‍CBC, ‍CRP

Treatments:

- Wound cleaning and irrigation

- No wound closure except for facial wounds

- Wound dressing

- ‍Analgesics

- ‍Antibiotics

- ‍Rabies prophylaxis

- Tetanus vaccination

- Education on bite wound prevention

Further care:

- Referral to plastic surgeon

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as redness, swelling, pus, or fever