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Rationale:
- Infection from a dog bite with Capnocytophaga canimorsus is more likely to occur in individuals with history of splenectomy, history of alcohol abuse, Hodgkin's lymphoma, idiopathic
thrombocytopenic purpura, chronic obstructive pulmonary disease, or in patients taking immunosuppressants, including corticosteroids.
- Patients with diabetes can present with advanced infection without typical clinical signs, including fever, leukocytosis,
and pain.
- Though uncommon, tetanus infection can be transmitted by mammalian bite wounds and is readily preventable with appropriate
treatment.
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Evidence:
- Capnocytophaga canimorsus septicemia, although rare, was fatal in 12 of 39 cases in one institution and is isolated from the normal flora of 16% of
dogs (4; 24).
- Hyperglycemia impairs polymorphonuclear leukocyte function, leading to a state of secondary immunodeficiency, which can increase
the risk of infection in patients with mammalian bites (25).
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Comments:
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Daniel G. Federman, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Jeffrey D. Kravetz, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Mammalian Bites
> Diagnosis
