Bite
Encyclopedia
A bite is a wound
received from the mouth
(and in particular, the teeth) of an animal
, including humans.
Animals may bite in self-defense, in an attempt to predate food, as well as part of normal interactions. Other bite attacks may be apparently unprovoked. Self inflicted bites occur in some genetic illnesses such as Lesch-Nyhan syndrome
. Biting is an act that occurs when an animal uses its teeth to pierce another object, including food
, flesh
and inanimate matter. A person bitten by an animal potentially carrying parvovirus
or rabies virus
should consult a medical doctor immediately. A bite victim may also incur serious bacterial infections of the bone called osteomyelitis
which can become life threatening if untreated, whether or not the animal has parvovirus
or rabies virus
.
Many different creatures are known to bite humans.
from infection by human oral ecology
and the possibility of transmission of blood-borne disease
s including, syphilis
and hepatitis
.
Involuntary biting injuries due to closed-fist injuries from fists striking teeth (referred to as reverse bite injuries
) are a common consequence of fist fights
. These have been termed "fight bites". Injuries in which the knuckle joints or tendon
s of the hand are bitten into tend to be the most serious.
In spite of their name, love bites are not biting injuries (they involve bruising from sucking, and the skin is not broken), although actual biting injuries are sometimes seen as the result of fetishistic activities.
or first aid
er including:
as necessary but not closed. Ampicillin/sulbactam
is indicated as HACEK endocarditis is the most worrying complication. A punctate wound over a joint surface should be regarded as an open joint injury until proven otherwise.
For empirical therapy, the first choice is amoxicillin with clavulanic acid, and if the person is penicillin allergy doxycycline
and metronidazole
. The anti-staphylococcal penicillins (e.g., cloxacillin
, nafcillin, flucloxacillin
) and the macrolide
s (e.g., erythromycin
, clarithromycin
) are not used for empirical therapy, because they do not cover Pasteurella
species.
ns and bat
s can transmit rabies
. The animal is caught alive or dead with its head preserved, so the head can later be analyzed to detect the disease. Signs of rabies include foaming at the mouth, self-mutilation, growling, jerky behavior, and red eyes. If the animal lives for ten days and does not develop rabies, then it is probable that no infection has occurred.
If the animal cannot be captured, prophylactic rabies treatment is recommended in most places. Certain places, such as Hawaii
, Australia
and the United Kingdom
, are known not to have native rabies. Treatment is generally available in North America
and the Northern European states.
TT = Tetanus Toxoid; TIG: Tetanus Immune globulin
are transmitted by mosquitoes.
behavior
and reaction for children 2.5 years and younger. Conversely children above this age have verbal skills to explain their needs and dislikes and biting is not age appropriate. Biting may be prevented by methods including redirection, changing the environment and responding to biting by talking about appropriate ways to express anger and frustration. School age children, those older than 2.5 years, who habitually bite may require professional help.
Biting is also a behavior found in many adult animals (including humans), often as part of sexual arousal. Some discussion of human biting appears in The Kinsey Report on Sexual Behavior in the Human Female.
Wound
A wound is a type of injury in which skin is torn, cut or punctured , or where blunt force trauma causes a contusion . In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.-Open:...
received from the mouth
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....
(and in particular, the teeth) of an animal
Animal
Animals are a major group of multicellular, eukaryotic organisms of the kingdom Animalia or Metazoa. Their body plan eventually becomes fixed as they develop, although some undergo a process of metamorphosis later on in their life. Most animals are motile, meaning they can move spontaneously and...
, including humans.
Animals may bite in self-defense, in an attempt to predate food, as well as part of normal interactions. Other bite attacks may be apparently unprovoked. Self inflicted bites occur in some genetic illnesses such as Lesch-Nyhan syndrome
Lesch-Nyhan syndrome
Lesch–Nyhan syndrome , also known as Nyhan's syndrome, Kelley-Seegmiller syndrome and Juvenile gout, is a rare inherited disorder caused by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyltransferase , produced by mutations in the HPRT gene located on X chromosome. LNS affects about...
. Biting is an act that occurs when an animal uses its teeth to pierce another object, including food
Food
Food is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals...
, flesh
Flesh
In vertebrate animals, flesh is the colloquial for biological tissue which consists of skeletal muscles and fat as opposed to bones, viscera and integuments. Flesh may be used as food, in which case it is called meat....
and inanimate matter. A person bitten by an animal potentially carrying parvovirus
Parvovirus
Parvovirus, often truncated to "parvo", is both the common name in English casually applied to all the viruses in the Parvoviridae taxonomic family, and also the taxonomic name of the Parvovirus genus within the Parvoviridae family...
or rabies virus
Rabies virus
The rabies virus is neurotropic virus that causes fatal disease in human and animals. Rabies transmission can occur through the saliva of animals....
should consult a medical doctor immediately. A bite victim may also incur serious bacterial infections of the bone called osteomyelitis
Osteomyelitis
Osteomyelitis simply means an infection of the bone or bone marrow...
which can become life threatening if untreated, whether or not the animal has parvovirus
Parvovirus
Parvovirus, often truncated to "parvo", is both the common name in English casually applied to all the viruses in the Parvoviridae taxonomic family, and also the taxonomic name of the Parvovirus genus within the Parvoviridae family...
or rabies virus
Rabies virus
The rabies virus is neurotropic virus that causes fatal disease in human and animals. Rabies transmission can occur through the saliva of animals....
.
Classification
Bites are usually classified by the type of creature causing the wound.Many different creatures are known to bite humans.
Arthropods
- Spider biteSpider biteA spider bite is an injury resulting from the bites of spiders or other closely related arachnids.Spiders are active hunters and rely heavily on their bites to paralyze and kill their prey before consuming it. They also bite in self defense...
- Insect bites and stings
- Flea bites are responsible for the transmission of bubonic plagueBubonic plaguePlague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...
. - Mosquito bites are responsible for the transmission of dengue feverDengue feverDengue fever , also known as breakbone fever, is an infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles...
and malariaMalariaMalaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
.
- Flea bites are responsible for the transmission of bubonic plague
Vertebrates other than humans
- Bites from dogDogThe domestic dog is a domesticated form of the gray wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties. The dog may have been the first animal to be domesticated, and has been the most widely kept working, hunting, and companion animal in...
s are commonplace, with children the most common victims and the face the most common target. About 4.7 million dog bites are reported annually in the United StatesUnited StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
. - Other companion animals, including catCatThe cat , also known as the domestic cat or housecat to distinguish it from other felids and felines, is a small, usually furry, domesticated, carnivorous mammal that is valued by humans for its companionship and for its ability to hunt vermin and household pests...
s, ferretFerretThe ferret is a domesticated mammal of the type Mustela putorius furo. Ferrets are sexually dimorphic predators with males being substantially larger than females. They typically have brown, black, white, or mixed fur...
s, and parrotsCompanion parrotCompanion parrot is a general term used for any parrot kept as a pet that interacts abundantly with its human counterpart. Generally, most species of parrot can make good companions....
, may bite humans. - WildlifeWildlifeWildlife includes all non-domesticated plants, animals and other organisms. Domesticating wild plant and animal species for human benefit has occurred many times all over the planet, and has a major impact on the environment, both positive and negative....
may sometimes bite humans. The bites of various mammals such as batBatBats are mammals of the order Chiroptera "hand" and pteron "wing") whose forelimbs form webbed wings, making them the only mammals naturally capable of true and sustained flight. By contrast, other mammals said to fly, such as flying squirrels, gliding possums, and colugos, glide rather than fly,...
s, rabbitRabbitRabbits are small mammals in the family Leporidae of the order Lagomorpha, found in several parts of the world...
s, wolves, raccoonRaccoonProcyon is a genus of nocturnal mammals, comprising three species commonly known as raccoons, in the family Procyonidae. The most familiar species, the common raccoon , is often known simply as "the" raccoon, as the two other raccoon species in the genus are native only to the tropics and are...
s, etc. may transmit rabiesRabiesRabies is a viral disease that causes acute encephalitis in warm-blooded animals. It is zoonotic , most commonly by a bite from an infected animal. For a human, rabies is almost invariably fatal if post-exposure prophylaxis is not administered prior to the onset of severe symptoms...
, which is almost always fatal if left untreated.
Human bites
Injuries from human bites present a particular risk to other humans, with a major risk of sepsisSepsis
Sepsis is a potentially deadly medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues...
from infection by human oral ecology
Oral ecology
Adult mouths may contain 500 to 1,000 different types of bacteria as part of the human flora and oral microbiology, but about 100 to 200 species may live in them at any given time. Those who care for their teeth and have a relatively clean mouth have 1,000 to 100,000 bacteria living on each tooth...
and the possibility of transmission of blood-borne disease
Blood-borne disease
A blood-borne disease is one that can be spread through contamination by blood.The most common examples are HIV, hepatitis B, hepatitis C and viral hemorrhagic fevers....
s including, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
and hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
.
Involuntary biting injuries due to closed-fist injuries from fists striking teeth (referred to as reverse bite injuries
Reverse bite injury
A reverse bite injury is when, after one person punches another person in the face, the skin of his or her knuckles are cut against the teeth of the person he or she is punching...
) are a common consequence of fist fights
Hand to hand combat
Hand-to-hand combat is a lethal or nonlethal physical confrontation between two or more persons at very short range that does not involve the use of firearms or other distance weapons...
. These have been termed "fight bites". Injuries in which the knuckle joints or tendon
Tendon
A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Tendons are similar to ligaments and fasciae as they are all made of collagen except that ligaments join one bone to another bone, and fasciae connect muscles to other...
s of the hand are bitten into tend to be the most serious.
In spite of their name, love bites are not biting injuries (they involve bruising from sucking, and the skin is not broken), although actual biting injuries are sometimes seen as the result of fetishistic activities.
Signs and symptoms
Bite wounds raise a number of medical concerns for the physicianPhysician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
or first aid
First aid
First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...
er including:
- Generalized tissue damage due to tearing and scratching.
- Serious hemorrhage if major blood vessels are pierced.
- InfectionInfectionAn infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
by bacteria or other pathogenPathogenA pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...
s, including rabiesRabiesRabies is a viral disease that causes acute encephalitis in warm-blooded animals. It is zoonotic , most commonly by a bite from an infected animal. For a human, rabies is almost invariably fatal if post-exposure prophylaxis is not administered prior to the onset of severe symptoms...
. - Introduction of venom into the wound by venomous animals such as some snakes.
- Introduction of other irritants into the wound, causing inflammationInflammationInflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
and itching.
Treatment
Bite wounds should be cleaned and debridedDebridement
Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue...
as necessary but not closed. Ampicillin/sulbactam
Ampicillin/sulbactam
Ampicillin/sulbactam is a combination of the common penicillin-derived antibiotic ampicillin and sulbactam, an inhibitor of bacterial beta-lactamase. Two different forms of the drug exist. The first, developed in 1987 and marketed in the United States under the tradename Unasyn, is an intravenous...
is indicated as HACEK endocarditis is the most worrying complication. A punctate wound over a joint surface should be regarded as an open joint injury until proven otherwise.
Treatment
Bite wounds are washed, ideally with povidone-iodine soap and water. The injury is then loosely bandaged, but is not sutured due to risk of infection.Antibiotics
Antibiotics prophylaxis is recommended for dog and cat bites of the hand and human bites if they are more than superficial. Evidence for the need for antibiotic prophylaxis for bites in other areas inconclusive.For empirical therapy, the first choice is amoxicillin with clavulanic acid, and if the person is penicillin allergy doxycycline
Doxycycline
Doxycycline INN is a member of the tetracycline antibiotics group, and is commonly used to treat a variety of infections. Doxycycline is a semisynthetic tetracycline invented and clinically developed in the early 1960s by Pfizer Inc. and marketed under the brand name Vibramycin. Vibramycin...
and metronidazole
Metronidazole
Metronidazole is a nitroimidazole antibiotic medication used particularly for anaerobic bacteria and protozoa. Metronidazole is an antibiotic, amebicide, and antiprotozoal....
. The anti-staphylococcal penicillins (e.g., cloxacillin
Cloxacillin
Cloxacillin is a semisynthetic antibiotic in the same class as penicillin. Cloxacillin was discovered and developed by Beecham. It is sold under a number of trade names, including Cloxapen, Cloxacap, Tegopen and Orbenin....
, nafcillin, flucloxacillin
Flucloxacillin
Flucloxacillin or floxacillin is a narrow-spectrum beta-lactam antibiotic of the penicillin class. It is used to treat infections caused by susceptible Gram-positive bacteria. Unlike other penicillins, flucloxacillin has activity against beta-lactamase-producing organisms such as Staphylococcus...
) and the macrolide
Macrolide
The macrolides are a group of drugs whose activity stems from the presence of a macrolide ring, a large macrocyclic lactone ring to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. The lactone rings are usually 14-, 15-, or 16-membered...
s (e.g., erythromycin
Erythromycin
Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and...
, clarithromycin
Clarithromycin
Clarithromycin is a macrolide antibiotic used to treat pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, pneumonia , skin and skin structure infections...
) are not used for empirical therapy, because they do not cover Pasteurella
Pasteurella
Pasteurella is a genus of Gram-negative, facultatively anaerobic bacteria. Pasteurella species are non-motile and pleomorphic. Most species are catalase-positive and oxidase-positive....
species.
Rabies
Animal bites inflicted by some animals, including carnivoraCarnivora
The diverse order Carnivora |Latin]] carō "flesh", + vorāre "to devour") includes over 260 species of placental mammals. Its members are formally referred to as carnivorans, while the word "carnivore" can refer to any meat-eating animal...
ns and bat
Bat
Bats are mammals of the order Chiroptera "hand" and pteron "wing") whose forelimbs form webbed wings, making them the only mammals naturally capable of true and sustained flight. By contrast, other mammals said to fly, such as flying squirrels, gliding possums, and colugos, glide rather than fly,...
s can transmit rabies
Rabies
Rabies is a viral disease that causes acute encephalitis in warm-blooded animals. It is zoonotic , most commonly by a bite from an infected animal. For a human, rabies is almost invariably fatal if post-exposure prophylaxis is not administered prior to the onset of severe symptoms...
. The animal is caught alive or dead with its head preserved, so the head can later be analyzed to detect the disease. Signs of rabies include foaming at the mouth, self-mutilation, growling, jerky behavior, and red eyes. If the animal lives for ten days and does not develop rabies, then it is probable that no infection has occurred.
If the animal cannot be captured, prophylactic rabies treatment is recommended in most places. Certain places, such as Hawaii
Hawaii
Hawaii is the newest of the 50 U.S. states , and is the only U.S. state made up entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean, southwest of the continental United States, southeast of Japan, and northeast of...
, Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
and the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, are known not to have native rabies. Treatment is generally available in North America
North America
North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...
and the Northern European states.
Tetanus
Tetanus toxoid is indicated for virtually any bite that punctures the epidermis and tetanus immune globulin is indicated in patients with more than 10 years since prior vaccination. Tetanus boosters (Td) should be given every ten years.| Prior toxoid | Clean minor wounds | All other wounds |
| <3 doses | TT: yes, TIG: no | TT: yes, TIG: yes |
| ≥3 doses | TT: if last dose ≥ 10yr TIG: no |
TT: if last dose ≥ 5yr, TIG: no |
TT = Tetanus Toxoid; TIG: Tetanus Immune globulin
Mosquito bites
Antihistamines are effective treatment for the symptoms from bites. Many diseases such as malariaMalaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
are transmitted by mosquitoes.
Behavior
Biting is an age appropriateAge appropriate
Age appropriate refers to a developmental concept whereby certain activities may be deemed appropriate or inappropriate to a child's "stage" or level of development....
behavior
Behavior
Behavior or behaviour refers to the actions and mannerisms made by organisms, systems, or artificial entities in conjunction with its environment, which includes the other systems or organisms around as well as the physical environment...
and reaction for children 2.5 years and younger. Conversely children above this age have verbal skills to explain their needs and dislikes and biting is not age appropriate. Biting may be prevented by methods including redirection, changing the environment and responding to biting by talking about appropriate ways to express anger and frustration. School age children, those older than 2.5 years, who habitually bite may require professional help.
Biting is also a behavior found in many adult animals (including humans), often as part of sexual arousal. Some discussion of human biting appears in The Kinsey Report on Sexual Behavior in the Human Female.