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dog bites or bite

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Animal bites are usually from dogs and cats in the United Kingdom. Typically, the hand is injuried during a defensive motion. The history is usually obvious; clinically there is cellulitis with associated lymphangitis. Osteomyelitis, tendon and joint injury also may occur.

The organisms involved is much the same as for human bites e.g. mixed anaerobes, streptococci. However, the Gram-negative coccus Pasteurella multocida is also common. The likelihood of rabies should be assessed in the history.

Any penetrating injury should be explored. Wound excision, irrigation and delayed closure may all be necessary. Treatment with antibiotics is mandatory. Radiography for foreign bodies may prove useful: all should be removed. Tetanus prophylaxis should be given. The hand should be splinted and elevated.