Sandbox/Alejandro: Difference between revisions

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==Overview==
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
 
|+
 
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Tuberculin Rection}}
==Common Pathogens==
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|Considered a Positive Result in:}}
 
 
{| class="wikitable"
|+Most common pathogens according to the type of bite
! style="width: 120px;background: #20538D"|{{fontcolor|#FFF| Bite}} !!style="width: 450px;background: #20538D"|{{fontcolor|#FFF Most Common Pathogens}}
|-
|-
| style="width: 120px;font-weight: bold;background: #DCDCDC"|Human|| ''[[Viridans streptococci]], [[S. epidermidis]], [[Corynebacterium]], [[S. aureus]], [[Eikenella]], [[Bacteroides]], Peptostreptococci ''
| style="padding: 5px 5px; background: #DCDCDC;" | '''≥ 5 mm '''
| style="padding: 5px 5px; background: #F5F5F5;" | 
*HIV-positive person
*Recent contacts of TB case
*Persons with nodular or fibrotic changes on CXR consistent with old healed TB
*Patients with organ transplants and other immunosuppressed patients
|-
|-
| style="width: 120px;font-weight: bold;background: #DCDCDC"|Dog || ''[[Pasteurella|Pasteurella canis]], [[S. aureus]] , [[Streptococci]] , [[Anaerobes]] ([[Bacteroides|Bacteroides spp]], [[Fusobacterium]], Prevotella heparinolytica, Proprionibacteria, and Peptostreptococci) ''
| style="padding: 5px 5px; background: #DCDCDC;" | '''≥ 10 mm  '''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Recent arrivals (less than 5 years) from high-prevalent countries
*Injection drug users
*Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)
*Mycobacteriology lab personnel
*Persons with clinical conditions that place them at high risk (e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-stage renal disease, chronic malabsorption syndromes, low body weight, etc)
*Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories
|-
|-
| style="width: 120px;font-weight: bold;background: #DCDCDC"|Cat ||''[[Pasteurella multocida]], [[S. aureus]], [[Streptococci]] , [[Anaerobes]] ([[Bacteroides|Bacteroides spp]], [[Fusobacterium]], Prevotella heparinolytica, Proprionibacteria, and Peptostreptococci)''
| style="padding: 5px 5px; background: #DCDCDC;" | '''≥ 15 mm '''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Persons with no known risk factors for TB
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Pig ||  ''[[Pasteurella|Pasteurella spp]], [[Gram-negative bacilli]], [[Gram-positive cocci]], [[Anaerobes]]''
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Monkey || ''[[Herpesvirus simiae]] ([[Monkey B virus|B Virus]])''
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Rat ||''[[Spirillum|Spirillum minus]], [[Streptobacillus|Streptobacillus moniliformis]]''
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Seal||''[[Mycoplasma|Mycoplasma spp]]''
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Camel ||
|}
==Treatment==
Bite [[wounds]] are washed, ideally with povidone-iodine soap and water.  The injury is then loosely bandaged, but is not sutured due to risk of infection.
Animal bites inflicted by [[carnivore]]s (other than rodents) are considered possible cases of [[rabies]]. The animal is caught alive or dead with its head preserved, so the head can later be analyzed to detect the disease.  Signs of [[rabies]] include foaming at the mouth, self-mutilation, growling, jerky behavior, and red eyes. If the animal lives for ten days and does not develop [[rabies]], then it is probable that no infection has occurred.
If the animal is gone, prophylactic [[rabies treatment]] is recommended.
The [[route of administration]] depends on the depth and severity of the [[wound]], as well as the time that has passed since the bite.
==Antibiotic Therapy==
{|
| valign=top |
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Antibiotic Prophylaxis'''
</font>
</div>
<div class="mw-customtoggle-table00" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Animal Bite'''
</font>
</div>
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table00" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Antibiotic Prophylaxis}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | Preferred Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 500-875/125 PO q8-12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | Alternative Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300 mg q8h'''''<br> OR <br> ▸ '''''[[Metronidazole]] 500 mg PO q8h'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg q12h'''''<br> OR <br> ▸ '''''[[TMP-SMX]] 160/800 mg PO q12h'''''<br> OR <br> ▸ '''''[[Penicillin VK]] 500 mg PO q6h'''''<br> OR <br> ▸ '''''[[Cefuroxime]] 500 mg PO q12h'''''<br> OR <br> ▸ '''''[[Moxifloxacin]] 400 mg PO q24h'''''
|-
|}
|}
|}
{|
| valign=top |
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Specific Therapy'''
</font>
</div>
<div class="mw-customtoggle-table10" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Bat Bite'''
</font>
</div>
<div class="mw-customtoggle-table09" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Camel Bite'''
</font>
</div>
<div class="mw-customtoggle-table03" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Cat Bite'''
</font>
</div>
<div class="mw-customtoggle-table02" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Dog Bite'''
</font>
</div>
<div class="mw-customtoggle-table01" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Human Bite'''
</font>
</div>
<div class="mw-customtoggle-table05" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Monkey / Primate Bite'''
</font>
</div>
<div class="mw-customtoggle-table04" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Pig (Swine) Bite'''
</font>
</div>
<div class="mw-customtoggle-table11" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Racoon Bite'''
</font>
</div>
<div class="mw-customtoggle-table06" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Rat Bite'''
</font>
</div>
<div class="mw-customtoggle-table08" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Seal Bite'''
</font>
</div>
<div class="mw-customtoggle-table12" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Skunk Bite'''
</font>
</div>
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table01" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Human Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 2 gm IV q8h'''''<BR> OR <BR> ▸ '''''[[Ticarcillin clavulanate]] 3.1 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Piperacillin-tazobactam]] 3.375 g IV q6-8h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300 mg PO q8h'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ciprofloxacin]] 500-750 mg IV q12h''''' <br> OR <br> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h''''' <br> OR <br> ▸ '''''[[TMP-SMX]] 160/800 mg q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Dog Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 500-875/125 PO q8-12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸  '''''[[Clindamycin]] 300 mg PO q8h'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ciprofloxacin]] 500-750 mg IV q12h''''' <br> OR <br> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h''''' <br> OR <br> ▸ '''''[[Gatifloxacin]] 400 mg q24h'''''
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Cat Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 500-875/125 PO q8-12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefuroxime]] 500 mg q12h''''' <br> OR <br>▸ '''''[[Doxycycline]] 100 mg q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table04" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Pig (Swine) Bite }}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg PO q12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 to 3 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Imipenem cilastatin]] 1 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 1 g q12 h''''' <BR> OR <BR> ▸ '''''[[Cefotaxime]] 2 g q6 h''''' <BR> OR <BR> ▸ '''''[[Ticarcillin clavulanate]] 3.1 g IV q6hr'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table05" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Monkey / Primate Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | Profilaxis
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Valacyclovir]]  1 g PO q8h x 14 days'''''<BR> OR <BR> ▸ '''''[[Acyclovir]] 800 mg PO 5 times/day'''''
|-
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen (without CNS symptoms)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Acyclovir]]  12.5–15 mg per kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen (with CNS symptoms)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left | ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | <small> Adapted from Prevention of and Therapy for B Virus Exposure • CID 2002:35<ref name="CohenDavenport2002">{{cite journal|last1=Cohen|first1=Jeffrey I.|last2=Davenport|first2=David S.|last3=Stewart|first3=John A.|last4=Deitchman|first4=Scott|last5=Hilliard|first5=Julia K.|last6=Chapman|first6=Louisa E.|title=Recommendations for Prevention of and Therapy for Exposure to B Virus (Cercopithecine Herpesvirus1)|journal=Clinical Infectious Diseases|volume=35|issue=10|year=2002|pages=1191–1203|issn=1058-4838|doi=10.1086/344754}}</ref></small>
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table06" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Uncomplicated Rat Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg orally q12h'''''
|-
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Rat Bite Fever}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Penicillin G]] 400,000 - 600,000 IU/day IV x 10-14 days (dose should be increased to 1.2 M if no clinical response)'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Streptomycin]] 15 mg/kg/day IM divided q12-24h x 10-14 days'''''<BR> OR <BR> ▸ '''''[[Tetracycline]]  250 to 500 mg orally q6h'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left |<small> Adapted from Clin. Microbiol. Rev. January 2007 vol.20 no.1 13-22 <ref name="Elliott2007">{{cite journal|last1=Elliott|first1=S. P.|title=Rat Bite Fever and Streptobacillus moniliformis|journal=Clinical Microbiology Reviews|volume=20|issue=1|year=2007|pages=13–22|issn=0893-8512|doi=10.1128/CMR.00016-06}}</ref></small>
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table08" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Seal Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | Preferred Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Tetracycline]] 1.5 g 1 dose, then 0.5 g q6h x 4-6 weeks'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | Alternative Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg q12h x 4-6 weeks'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5;align=left |<small> Adapted from Journal of Infection (2002) 45: 71±75 <ref name="HartleyPitcher2002">{{cite journal|last1=Hartley|first1=J.W.|last2=Pitcher|first2=D.|title=Seal Finger—Tetracycline is First Line|journal=Journal of Infection|volume=45|issue=2|year=2002|pages=71–75|issn=01634453|doi=10.1053/jinf.2002.1027}}</ref></small>
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table09" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Camel Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | Preferred Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[['''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | Alternative Regimen '''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[C''''' <br> OR <br>▸ '''''[[D'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table10" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Bat Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg orally q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table11" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Racoon Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg orally q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table12" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Skunk Bite}}
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''
|-
|  style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center  | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg orally q12h'''''
|-
|}
|}
|}
|}
==Vaccination==
===Tetanus Prophylaxis===
===Rabies Prophylaxis===
==References==
{{reflist|2}}

Latest revision as of 13:10, 4 September 2014

Tuberculin Rection Considered a Positive Result in:
≥ 5 mm
  • HIV-positive person
  • Recent contacts of TB case
  • Persons with nodular or fibrotic changes on CXR consistent with old healed TB
  • Patients with organ transplants and other immunosuppressed patients
≥ 10 mm
  • Recent arrivals (less than 5 years) from high-prevalent countries
  • Injection drug users
  • Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)
  • Mycobacteriology lab personnel
  • Persons with clinical conditions that place them at high risk (e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-stage renal disease, chronic malabsorption syndromes, low body weight, etc)
  • Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories
≥ 15 mm
  • Persons with no known risk factors for TB
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