Bite

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List of terms related to Bite

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A bite is a wound received from the mouth (and in particular, the teeth) of an animal or person. Animals may bite in self-defense, in an attempt to predate food, as well as part of normal interactions. Other bite attacks may be apparently unprovoked, especially in the case of bites committed by psychologically or emotionally disturbed humans. Some disorders such as Lesch-Nyhan syndrome may cause people to bite themselves.

Bite wounds raise a number of medical concerns for the physician or first aider including:

• Generalized tissue damage due to tearing and scratching.
• Serious hemorrhage if major blood vessels are pierced.
• Infection by bacteria or other pathogens, including rabies.
• Introduction of venom into the wound by venomous animals such as some snakes.
• Introduction of other irritants into the wound, causing inflammation and itching.

Examples

• Flea bites are responsible for the transmission of bubonic plague.
• Mosquito bites are responsible for the transmission of malaria.
• The bites of various animals may transmit rabies.

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 carnivores (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 in most places. Certain places, such as Hawaii, Australia and the United Kingdom, are known not to have native rabies. Treatment is generally available in North America and the Northern European states.

Antibiotic Therapy

▸ Click on the following categories to expand treatment regimens.

Human Bites   ▸  Adults   ▸  Children

Early (not yet infected) Preferred Regimen ▸ Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days Alternative Regimen (beta-lactam allergy) ▸ Moxifloxacin 400 mg orally q6h AND Clindamycin 300 mg orally q6h OR ▸ Trimethoprim-sulfamethoxazole 1 double-strength tablet orally q12h AND metronidazole 250 to 500 mg orally q6h Late (infected) Preferred Regimen ▸ Ampicillin sulbactam 1.5 gm IV q6h OR ▸ Cefoxitin 2 gm IV q8h OR ▸ Ticarcillin clavulanate 3.1 gm IV q6h OR ▸ Piperacillin-tazobactam 3.375 gm IV q6h or 4.5 gm q8h or 4-hr infusion of 3.375 gm q8h Alternative Regimen (beta-lactam allergy) ▸ Clindamycin 1.5 gm IV q6h PLUS ▸ Moxifloxacin 400 mg IV q6h Early (not yet infected) Preferred Regimen ▸ Amoxicillin-clavulanate (> 12weeks) 45 mg/kg/day orally in 2 divided doses for 5 days Late (infected) Preferred Regimen ▸ Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h OR ▸ Cefoxitin 80 to 160 mg/kg/day IV in 4 divided doses OR ▸ Ertapenem (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR Ertapenem (>13years) 1 g IV once daily

Behavior

Biting is an age appropriate behavior and reaction for children 2.5 years and younger. Conversely children above this age have verbal skills to explain their needs and dislikes and biting is not age appropriate. Biting may be prevented by methods including redirection, changing the environment and responding to biting by talking about appropriate ways to express anger and frustration. School age children, those older than 2.5 years, who habitually bite may require professional help.

Biting is also a behavior found in many adult animals (except people),often as part of sexual petting.

See Also

• Snakebite
• Spider bite
• Wilderness first aid
• Insect bites and stings

External links

• Treating human bites