Animal bites

Last reviewed: 9 Nov 2022
Last updated: 19 Jul 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • circumstances of animal bite
  • wound description
  • erythema
  • induration
  • fluctuance
  • purulent drainage
  • regional adenopathy
  • necrotic tissue
  • vital signs unstable
More key diagnostic factors

Risk factors

  • age <14 years
  • pet ownership
  • high-risk groups (for rabies infection)
  • immunosuppression (increased risk of infection if bitten)
  • diabetes (increased risk of infection if bitten)
  • previous mastectomy (increased risk of infection if bitten)
  • splenectomy (increased risk of infection if bitten)
  • liver disease (increased risk of infection if bitten)
More risk factors

Diagnostic investigations

1st investigations to order

  • wound cultures
  • x-ray
More 1st investigations to order

Investigations to consider

  • FBC
  • blood cultures
  • angiography
  • photography
  • DNA swab
More investigations to consider

Treatment algorithm

ACUTE

uninfected wounds

uncomplicated infected bite: not penicillin-allergic

uncomplicated infected bite: penicillin-allergic

complicated bites: not penicillin-allergic

complicated bites: penicillin-allergic

Contributors

Authors

Oliver Spencer, MBBS, BSc, MRCS, FRCEM

Consultant, Emergency Medicine

Croydon University Hospital NHS Trust

London

UK

Disclosures

OS declares that he has no competing interests.

Subhro Banerjee, MBBS, FRCEM

Consultant, Emergency Medicine

Croydon University Hospital

London

UK

Disclosures

SB has no competing interests.

Acknowledgements

Dr Oliver Spencer and Dr Subhro Banerjee would like to gratefully acknowledge Dr A. Parfitt, Dr Randy Taplitz, and Dr Eric Chang, the previous contributors to this topic. AP and EC declare that they have no competing interests. RT has received funding from Pfizer to attend several antifungal symposia and funding from Schering-Plough to attend an antifungal Speaker's Bureau Workshop.

Peer reviewers

Cynthia Christy, MD

Associate Chief of Pediatrics

General Pediatrics/Pediatric Infectious Diseases

University of Rochester

New York

NY

Disclosures

CC declares that she has no competing interests.

Gregory Conners, MD, MPH, MBA, FAAP, FACEP

Interim Chair of Emergency Medicine

Professor of Emergency Medicine and Pediatrics

University of Rochester

New York

NY

Disclosures

GC declares that he has no competing interests.

Jeffrey R. Suchard, MD, FACEP, FACMT

Professor of Clinical Emergency Medicine

Director of Medical Toxicology

Department of Emergency Medicine

University of California

Irvine Medical Center

Orange

CA

Disclosures

JRS declares that he has no competing interests.

  • Animal bites images
  • Differentials

    • Soft tissue injury
    More Differentials
  • Guidelines

    • Recommended immunization schedule for children and adolescents 18 years or younger
    • Recommended immunization schedule for adults aged 19 years or older
    More Guidelines
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer