Cases reported "Bites and Stings"

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1/20. pasteurella multocida meningitis and septic arthritis secondary to a cat bite.

    Animal bites are seen almost daily in the emergency department, and the majority heal without complication. pasteurella multocida is frequently the causative organism of localized wound infections and cellulitis in this patient population. P. multocida infection is usually associated with close contact with pets, such as dogs and cats, that harbor this organism as normal oral flora. meningitis and septic arthritis are very rare sequelae of P. multocida infection. This case report presents a patient with P. multocida bacteremia, meningitis, and septic arthritis developing together as a complication of a cat bite.
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keywords = wound infection
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2/20. vacuum-assisted closure in the treatment of a 9-year-old child with severe and multiple dog bite injuries of the thorax.

    The vacuum-assisted closure (VAC; KCI International, San Antonio, TX) device is a negative pressure dressing, which we have used in the treatment of wounds with devitalized or infected tissues. Although introduced in plastic and reconstructive surgery, its use has extended to orthopedic and cardiothoracic surgical practice in the treatment of infected joint replacement and sternal wound infections, respectively. Although the VAC is becoming more widely used in surgical practice, only a small number of case reports exist in addition to the original case series by Argenta and Morykwas in 1997. Previously, the device was described in treating single wounds in adult patients. We report a case where it was successfully used to treat multiple dog bite injuries in a 9-year-old child.
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keywords = wound infection
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3/20. Management of eyelid dog bites.

    Eyelid dog bites are common facial injuries that occur frequently in children and often involve the lacrimal canaliculi. Even though the incidence of infection following repair of these lacerations is low, prophylactic antibiotics should be administered to all patients. Good function and appearance of repaired eyelid dog bites is achieved with appropriate surgical management. This article presents 2 cases and a retrospective review of 7 patients with eyelid dog bite injuries evaluated and treated between August 1989 and June 1994; 6 of 9 patients were children. The lacrimal drainage system was lacerated in 6 of 9 patients. All patients underwent surgical repair of their injuries and received antibiotics directed at common canine oral bacterial flora. The patients were followed for a minimum of 3 months postoperatively. There was only 1 case of facial wound infection. Good functional results were achieved in all patients.
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4/20. wound infection with neisseria weaveri and a novel subspecies of pasteurella multocida in a child who sustained a tiger bite.

    A 7-year-old girl developed a wound infection as a result of a tiger bite she sustained. dna sequence analysis revealed that the causative organisms were neisseria weaveri and what is, to our knowledge, a previously undescribed subspecies of pasteurella multocida, for which we propose the designation "pasteurella multocida subspecies tigris subspecies nov."
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keywords = wound infection
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5/20. Cat bite in an old patient: is it a simple injury?

    An 84-year-old woman bitten by her domestic cat developed a severe wound infection caused by pasteurella multocida. Although she was treated with antibiotics according to the bacterial sensitivity, the infection progressed to sepsis and became complicated by transient renal failure caused by interstitial nephritis. The need in the emergency department for a thorough examination of patients with domestic animal-inflicted injuries, the indication for surgical debridement, and the isolation of the offender by early obtained cultures are considered. The administration of the properly chosen antibiotics and prophylactic vaccination against rabies and tetanus are discussed.
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keywords = wound infection
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6/20. endocarditis due to staphylococcus aureus after minor dog bite.

    Living in a society of animal lovers, the dangers are often not always apparent. Injury from bites and scratches is an occupational hazard for those people who work with animals. Despite the high risk of secondary wound infection as a result of an animal bite, many patients do not receive treatment with an antimicrobial medication. This report describes a case of a previously fit and well 66-year-old female dog handler who, after an apparently minor dog bite to the hand, developed fulminant acute staphylococcus aureus endocarditis and life-threatening aortic regurgitation. This article discusses the microbiology behind dog bites and highlights the need for proper wound hygiene and consideration of prophylactic broad-spectrum antibiotics to prevent potentially fatal outcomes as a result of what initially seem to be minor injuries.
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keywords = wound infection
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7/20. vibrio fluvialis hemorrhagic cellulitis and cerebritis.

    We describe a case of vibrio fluvialis hemorrhagic cellulitis and cerebritis following multiple fire-ant stings and wading in brackish water. A high index of suspicion is required for diagnosis of this specific pathogen and concordant infection. This is, to our knowledge, the first report of this type of wound infection.
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keywords = wound infection
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8/20. The emergency management of moray eel bites.

    As human encounters with hazardous marine life increase, emergency physicians are more frequently confronted with the management of resultant injuries. We present three cases involving hand injuries inflected by moray eels. Each was managed with local wound care and subsequent outpatient treatment with either oral ciprofloxacin or cefuroxime. One patient had mild residual hand dysfunction, and no patient developed wound infection. To better assess the bacteriology of such injuries, oral cultures were taken from captive moray eels and surrounding aquarium water. culture and sensitivity analyses showed vibrio and pseudomonas to be the predominant species, both sensitive to ciprofloxacin, cefuroxime, tetracycline, and trimethoprim-sulfamethoxazole. We conclude that moray eel bites can be managed successfully with aggressive, local wound care and antibiotic coverage that targets vibrio and pseudomonas species.
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keywords = wound infection
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9/20. Bite wound infections of the lower extremity.

    Animal bite wounds of the lower extremity are considered high-risk wounds for infection, especially in the medically compromised individual. Management should be aggressive. Copious irrigation and debridement of the wound clearly proves to be of greater value in the prevention of infection than the indiscriminate use of so-called "prophylactic" antibiotic agents. Frankly infected wounds must also be managed aggressively, incorporating the use of antibiotics to eradicate the infection. Empiric use of an agent containing clavulanic acid or sulbactam is suggested until results are obtained from the bacterial culture and sensitivity. tetanus prophylaxis should be considered for every bite wound, whereas rabies prophylaxis is warranted in selected cases.
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keywords = wound infection
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10/20. erythromycin failure with subsequent pasteurella multocida meningitis and septic arthritis in a cat-bite victim.

    We report the case of a 75-year-old woman who developed pasteurella multocida meningitis and septic arthritis while being treated for a cat-bite wound infection with erythromycin. review of the literature revealed that erythromycin has poor in vitro activity against this bacterium and has been associated with serious clinical failures. We recommend that erythromycin not be prescribed for empiric therapy of established animal-bite infections. Suggestions for optimal empiric therapy of animal-bite infections and the differential diagnosis of severe cat-bite-associated sepsis are discussed.
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keywords = wound infection
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