Laboratory Studies
Fresh bite wounds without signs of infection do not need to be cultured. Infected bite wounds should be cultured to help guide future antibiotic therapy.
Other laboratory tests are indicated as the patient's condition dictates (eg, complete blood cell count and blood cultures for patients with sepsis).
If Capnocytophaga canimorsus sepsis is suspected, examine the peripheral smear for the organism, a bacillus.
Imaging Studies
Radiography is indicated if any concerns exist that deep structures are at risk (eg, hand wounds; deep punctures; crushing bites, especially over joints). Occult fractures or osteomyelitis may be discovered. Radiographs may find foreign bodies in the wound (eg, teeth).
Children who have been bitten in the head should be examined for bony penetration with plain films or a computed tomography (CT) scan. If the child was shaken, consider cervical spine evaluation.
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Animal bites. The devastating damage sustained by a preadolescent male during a dog attack. Almost lost in this photograph is the soft tissue damage to this victim's thigh. This patient required 2 units of O- blood and several liters of isotonic crystalloid. Repair of these wounds required a pediatric surgeon, an experienced orthopedic surgeon, and a plastic surgeon. Attacks such as these have caused a movement in some areas of the country to ban certain dog breeds.
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Animal bites. Massive soft tissue damage of the right leg caused by a dog attack. This patient was transferred to a level one pediatric trauma center for care. At times, staff members may need counseling after caring for mauled patients.
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Animal bites. Massive soft tissue damage of the lower left leg caused from a dog attack. Most of the fatalities from dog bites are children.
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Animal bites. A different angle of the patient in Image 3 showing the massive soft tissue damage to this child's left lower leg.
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Animal bites. Wounds to the left arm and hip inflicted during a dog attack.
