Human Bites Workup

  • Author: Ian K McLeod, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Dec 2, 2011
 

Laboratory Studies

  • Laboratory studies are required if bacteremia or sepsis is suspected.
  • Obtain appropriate baseline viral titers from the patient and the assailant (if applicable and available).
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Imaging Studies

  • Radiographs may be useful in evaluating foreign bodies (eg, tooth fragments), air in a joint, or injuries occurring over bone to reveal fractures.
  • Radiographs of chronic wounds may reveal underlying osteomyelitis.
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Other Tests

  • Routine culture of every human bite wound is unnecessary.
    • Cultures are costly, demonstrate no growth in more than 80% of cases, and rarely alter first-line therapy.
    • Furthermore, wounds that subsequently manifest signs of infection often have bacteriologic profiles that differ from those shown on initial cultures.
  • Cultures are indicated in wounds with signs of infection (eg, cellulitis, swelling, purulence) and in wounds showing no clinical improvement despite appropriate antimicrobial therapy.
    • Obtain aerobic and anaerobic cultures, and grow them for 7-10 days to identify slow-growing pathogens. This will allow for the quantification and identification of bacterial species and their antibiotic susceptibilities.
    • Obtain cultures before the start of antimicrobial therapy whenever possible.
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Contributor Information and Disclosures
Author

Ian K McLeod, MD  Assistant Professor, Department of Surgery, Uniformed Services University of the Health Sciences; Chief, Otolaryngology Service, DeWitt Army Community Hospital

Ian K McLeod, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Daniel J Gallagher III, MD  Attending Surgeon, Department of Otolaryngology, Walter Reed and DeWitt Army Hospitals

Daniel J Gallagher III, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Clark A Rosen, MD  Director, University of Pittsburgh Voice Center; Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine

Clark A Rosen, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Pennsylvania Medical Society

Disclosure: Bioform Medical Consulting fee Consulting; Bioform Medical Consulting fee Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

David W Stepnick, MD  Associate Professor, Departments of Plastic Surgery and Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, University Hospitals of Cleveland Case Medical Center

David W Stepnick, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

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