Summary
Definition
Anamnesis y examen
Principales factores de diagnóstico
- circumstances of animal bite
- wound description
- erythema
- induration
- fluctuance
- purulent drainage
- regional adenopathy
- necrotic tissue
- vital signs unstable
Factores de riesgo
- age <14 years
- pet ownership
- high-risk groups (for rabies infection)
- previous medical procedures (increased risk of infection if bitten)
- underlying medical conditions (increased risk of infection if bitten)
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- wound cultures
- x-ray
Pruebas diagnósticas que deben considerarse
- CBC
- blood cultures
- angiography
- photography
- DNA swab
Algoritmo de tratamiento
uninfected wounds
uncomplicated infected bite: not penicillin-allergic
uncomplicated infected bite: penicillin-allergic
complicated bites: not penicillin-allergic
complicated bites: penicillin-allergic
Colaboradores
Autores
Oliver Spencer, MBBS, BSc, MRCS, FRCEM
Consultant, Emergency Medicine
Croydon University Hospital NHS Trust
London
UK
Divulgaciones
OS declares that he has no competing interests.
Subhro Banerjee, MBBS, FRCEM
Consultant, Emergency Medicine
Croydon University Hospital
London
UK
Divulgaciones
SB has no competing interests.
Agradecimientos
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.
Revisores por pares
Cynthia Christy, MD
Associate Chief of Pediatrics
General Pediatrics/Pediatric Infectious Diseases
University of Rochester
New York
NY
Divulgaciones
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
Divulgaciones
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
Divulgaciones
JRS declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Rao AK, Briggs D, Moore SM, et al. Use of a modified preexposure prophylaxis vaccination schedule to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices - United States, 2022. MMWR Morb Mortal Wkly Rep. 2022 May 6;71(18):619-27.Texto completo Resumen
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52.Texto completo Resumen
National Institute for Health and Care Excellence. Human and animal bites: antimicrobial prescribing. November 2020 [internet publication].Texto completo
Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices recommended immunization schedule for adults ages 19 years or older, United States, 2025. Nov 2024 [internet publication].Texto completo
Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices recommended immunization schedule for children and adolescents ages 18 years or younger, United States, 2025. Nov 2024 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Soft tissue injury
Más DiferencialesGuidelines
- Recommended immunization schedule for adults aged 19 years or older
- Recommended immunization schedule for children and adolescents 18 years or younger
Más Guías de práctica clínica
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