小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 动物咬伤情况
- 伤口描述
- 红斑
- 硬结
- 波动性
- 脓化流水
- 局部淋巴结肿大
- 组织坏死
- 生命体征不稳
危险因素
- 14岁以下
- 宠物所有权
- 高风险人群（针对狂犬病感染）
- 免疫抑制（如被咬伤，感染风险将增加）
- 糖尿病（如被咬伤，感染风险将增加）
- 曾接受乳房切除术（如被咬伤，感染风险将增加）
- 脾切除术（如被咬伤，感染风险将增加）
- 肝脏疾病（如被咬伤，感染风险将增加）
诊断性检查
首要检查
- 伤口微生物培养检查
- X 光
需考虑的检查
- 全血细胞计数 (FBC）
- 血培养
- 血管造影术
- 影像学检查
- DNA拭子
治疗流程
未感染伤口
合并感染但无并发症的咬伤：无盘尼西林过敏
合并感染但无并发症的咬伤：盘尼西林过敏
合并感染的复杂咬伤：无盘尼西林过敏
合并感染的复杂咬伤：盘尼西林过敏
撰稿人
作者
Oliver Spencer, MBBS, BSc, MRCS, FRCEM
Consultant, Emergency Medicine
Croydon University Hospital NHS Trust
London
UK
利益声明
OS declares that he has no competing interests.
Subhro Banerjee, MBBS, FRCEM
Consultant, Emergency Medicine
Croydon University Hospital
London
UK
利益声明
SB has no competing interests.
鸣谢
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.
同行评议者
Cynthia Christy, MD
Associate Chief of Pediatrics
General Pediatrics/Pediatric Infectious Diseases
University of Rochester
New York
NY
利益声明
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
利益声明
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
利益声明
JRS declares that he has no competing interests.
鉴别诊断
- 软组织损伤
更多 鉴别诊断指南
- 18 岁及 18 岁以下儿童和青少年的推荐免疫接种程序
- 19 岁及 19 岁以上成人的免疫接种推荐时间表
更多 指南
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