Human/Animal Bites

Human bite wounds may not seem dangerous, but the risk of infection is high. These wounds contain very high levels of bacteria. Even though the wound may appear minor, an infection can lead to a severe joint infection. About one third of all hand infections are caused by human bite wounds. These infections can move quickly and cause major complications, including destruction of the joint, if not treated promptly.

Each year millions of people in the United States are bitten by animals. Most bites occur on the fingers of the dominant hand, but animal bites can also occur about the head and neck area.

Cause

A human bite wound can be caused directly–a child bites another child. A human bite wound also can be caused indirectly–a hand strikes a tooth, breaking the skin on the hand. A punch to the mouth can result in an indirect bite injury at the knuckle joint (metacarpophalangeal joint).

Most animal bites are from dogs. Cat bites are the second most common cause of bites. The risk of infection from a cat bite is much higher than a bite from a dog.

A major concern about an animal bite is the possibility of rabies.

Because most pets in the United States are vaccinated, most cases of rabies result from the bite of a wild animal, such as a skunk, bat, or raccoon. Only a few people die from rabies in the United States each year, and most deaths are due to bat bites. In other countries, dog bites are the most common source of rabies. Rabies causes an estimated 55,000 deaths worldwide each year.

Symptoms

In some cases, the bite will not break the skin, but may cause damage to underlying tendons and joints. If the skin is broken, there is the possibility of infection as well as injury to joints, tendons, and nerves.

An injury to the top of the hand can result in significant swelling within hours.

Signs of an Infection:

  • Warmth around the bite wound
  • Swelling
  • Pain
  • A pus discharge
  • Signs of Tendon or Nerve Damage
  • An inability to bend or straighten the finger.
  • A loss of sensation over the tip of the finger.

Diagnosis

Be prepared to tell your Wisconsin Bone & Joint doctor how you got the bite. During your visit, your doctor will perform an examination.

Your doctor will measure the wound, note its location, and check for signs of nerve or tendon damage. He or she may examine your arm for red lines, which are a sign of a spreading infection.

Your doctor may order x-rays and a blood test. In addition, he or she may give you a tetanus shot and prescribe antibiotics.

You may need to return to your doctor’s office a day or two after your first visit. At that time, your doctor can confirm that you have not developed an infection.

If your tendons or nerves have been injured, you may need to see a specialist for additional treatment. Surgery may be necessary if you have an infected joint or tendon.

Treatment

Bites can transmit diseases to another person. These may even include the human immunodeficiency virus (HIV), the hepatitis B and C virus, and syphilis. See a doctor within 24 hours of the injury if the skin is broken.

Superficial Bites
If you have a bite, follow these precautions.

  • Do not put the bitten area in your mouth. This adds bacteria into the wound.
  • If the skin around the wound is not broken, wash the wound thoroughly. Use soap and water or an antiseptic, such as hydrogen peroxide.
  • Apply an antibiotic ointment to the area and cover with a nonstick bandage.
  • Watch the area carefully. Are there signs of damaged nerves or tendons? If the fingers cannot be straightened or bent or if there is numbness, seek medical help.

Deep Wounds

  • If the skin around the wound is broken and bleeding, apply direct pressure with a clean, dry cloth.
  • Elevate the area.
  • Do not clean a wound that is actively bleeding.
  • Cover the wound with a clean dressing and seek medical help.
  • To prevent complications from a deep wound, get medical attention within 24 hours of being bitten. Surgery is indicated for suspected joint or tendon infection.

Animal Bites

Immediate First Aid
The bitten area should not be put into the mouth. The mouth contains bacteria, which can cause infection.

Superficial Wounds

  • For superficial wounds, the area should be washed thoroughly with soap and water or an antiseptic, such as hydrogen peroxide or alcohol.
  • An antibiotic ointment should be applied and the wound should be covered with a nonstick bandage.

The area should be watched carefully for signs of damaged nerves or tendons. Some bruising may develop. The wound should heal within a week to 10 days. If it does not, or if there are signs of infection or damage to nerves and tendons, medical help should be sought.

Presence of Bleeding
Direct pressure should be applied to the area using a clean dry cloth and the area should be elevated. If an area is not actively bleeding, it should not be cleaned.

The wound should be covered with a clean sterile dressing and medical attention should be sought.

If the wound is to the face, head, or neck, medical help should be sought immediately.

Medical assistance
The physician will probably leave the wound open (without stitches), unless there is a facial wound. Xrays and a blood test may be needed. A tetanus shot and a prescription for antibiotics may be prescribed.

If the tendons or nerves have been injured, a specialist may be consulted for additional treatment.

The incident should be reported to the public health department. They may ask for assistance in locating the animal. This is so that the animal can be confined and observed for symptoms of rabies.

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