Active substances: Doxycycline
Those presenting in fewer than 24 hours from injury without signs of infection should have X-rays and their wounds explored under sterile conditions to exclude deep structure injury.
Those with tendon injury, joint penetration, retained foreign body, or fracture should be referred to the consultant.
Treatment of Human Bites. As with animal bites, infections from human bites are polymicrobial in nature, with an average of five pathogens isolated from each wound.
Antibiotic recommendations are given in Table 1. Another consideration in human bites is the transmission of contagious diseases.
Unfortunately, many disease have been documented to be transmitted via human bites, such as HIV, herpes, syphilis, tuberculosis, herpes, hepatitis C, and hepatitis B. Primary closure of occlusional human bite wounds in the majority of cases is not a concern as most bites to the trunk or limbs are crush injuries, or produce only superficial abrasions.
All puncture wounds should be left open.
Bites to the hand or fight bites should be left open as well although a recent case report exists of a primary tendon repair that was closed successfully.
Any extensor tendon injury highly correlates with joint penetration. The detection of any deep structure injury should prompt consultation with the hand consultant for possible admission. Likewise, any patient with an infected fight bite should be admitted for further treatment.
Occasionally bites to smaller areas such as the nose, ears, or fingers can result in lacerations, avulsions, or amputations. True tissue defects or amputations require specialty consultation for definitive management, but the question of whether to close lacerations from human bite wounds can be controversial.
In general, most recent emergency medicine texts agree that primary closure of deforming facial bite wounds can be performed safely. If any signs of infection already are present, or the physician is not comfortable with primary closure, careful debridement followed by delayed closure 2-3 days is a good alternative.
Though actual numbers are not possible to obtain, insect envenomations occur in the millions every year.
Venomous insects also account for more deaths annually than do snake envenomations. In contrast to venomous reptiles where the toxicity of the venom is responsible for deaths, the majority of deaths from insect encounters come as a result of anaphylactic reactions to the venom.
As humans are not prey for any carnivorous insect, envenomation by the insect is strictly defensive, accidental, or reflexive. Though a large number of insects can sting or bite people, this discussion will focus only on those that are medically significant.
As with all bites and stings, tetanus prophylaxis is recommended if not already current, but bites and stings from insects are not particularly associated with tetanus infection.
Fear of spiders arachnophobia is a very common fear and dates back to the Middle Ages when spiders were thought to be carriers of the plague, and many diseases were thought to be a result of spider bites.
The truth is that spiders are small carnivores that likely prevent disease by preying on insects that do carry disease i. There are roughly 34,000 species of spiders found in the world and they have managed to colonize all habitats except the open ocean.
All spiders have eight legs attached to the thorax and the unique ability to produce silk from the spinneretes on their abdomens.
Venom is produced by glands near the jaws located under the eyes.