Diagnosis
"I was bit by a ....." fill in your blank. Humans, while animals are covered here: Bites, human.
Epidemiologic Risks
Sticking your hand or other body parts near the mouth of an animal.
Microbiology
Depends on the animal, that list is here: Zoonosis. For cats and dogs Pasteurella, anaerobes, streptococci lead the list. Each animal has its own flora.
It depends on what other animal the biting animal has recently had in its mouth. Plague and tularemia are two of the classics that could be spread by a bite or a lick.
Empiric Therapy
Amoxicillin-clavulanic acid for most bites after wound cleaning and a tetanus shot.
Rabies issues here. Usually, worry about rabies from an unprovoked attack: if you interact with the animal in any way, then it is usually not considered unprovoked.
Cat bites
Amoxicillin-clavulanic acid for prophylaxis.
For real infections use real antibiotics directed against the flora of a cat mouth: (ampicillin OR third-generation cephalosporins) PLUS metronidazole would be good choices. If PCN allergic use (doxycycline OR a quinolone) AND (clindamycin OR metronidazole). Pasteurella are usually resistant to first-generation cephalosporins.
Dog Bites
Amoxicillin-clavulanic acid for prophylaxis.
For real infections use real antibiotics directed against the flora of a dog's mouth: (ampicillin OR third-generation cephalosporins) PLUS metronidazole would be good choices. If PCN allergic use (doxycycline OR a quinolone) AND (clindamycin OR metronidazole). Pasteurella are usually resistant to first-generation cephalosporins.
In splenectomy, patients can flame out from sepsis from Capnocytophagia canimorsus. It should be sensitive to near about all beta-lactams.
Specific Therapy
Debride, then
Prophylaxis is usually for 10 days.
Soft-tissue infections (cellulitis or abscess) is iv until afebrile, then po for a total of 10-14 days. Septic arthritis or tenosynovitis is 2 -3 weeks of iv.
Osteomyelitis is usually 6 weeks of iv. And do not forget the tetanus shot.
Pearls
Pasteurella usually occurs in the first 48 hours after a bite.
Zombie bites? Nothing to do. You will become one yourself, feasting on brains, until a gunshot to the head. Unless you follow the results of When zombies attack!: Mathematical modeling of an outbreak of zombie infection.
Last Update: 05/06/18.