Cat bites can also lead to bone infection, and in extreme cases, septic shock, which is a life-threatening condition. The infection resides in synovial or periarticular tissues and is usually bacterialin younger adults read more and osteomyelitis Osteomyelitis Osteomyelitis is inflammation and destruction of bone caused by bacteria, mycobacteria, or fungi. Cat Bites: Dont Take Them Lightly (Info & Treatment). Some bruising may develop, but the wound should heal within a week to 10 days. The researchers studied nearly 200 cat bite cases that occurred between 2009 and 2011. (2016). Cat bite; animal bite; infection. Within a couple of hours the area was in severe pain, swollen, and red. reported a staggering 28-80 percent cat bite infection rate. Positive tactile response to the digits of the right hand was achieved. Cat bites create narrow, deep puncture wounds. Apparently, cats have a bacteria in their saliva that aids in their digestion, which can be lethal if it gets into a human being's blood stream. J Hand Surg Am. In the case of dogs and cats, thats not always the case. Last Updated on: January 25, 2023 by Crystal Uys. The subjects were 18 females and two males aged 27-86 years (mean age of 58 years). A small puncture wound, particularly from a human or cat bite, may involve significant injury to the tendon, joint capsule, or articular cartilage. The family cat lunged at him and bit and scratched his hand. "Every time they would stitch me up after flushing the wound the infection would just get worse. Some people need surgery, though. (2016). and Any time the skin is punctured, you will experience some level of discomfort, but this initial pain should subside. extreme lower back pain after a nasty cat bite that required intravenus antibiotics in the hospital followed up with pain meds and antibiotics antiinflammatory meds, swelling decreasing throbbing pain decreasing, back pain is unbearable. Bethesda, MD 20894, Web Policies for three to five days or one double-strength trimethoprim/sulfamethoxazole tablet b.i.d. "Cats' teeth are sharp and can penetrate very deeply. Multiple scratch wounds of various lengths across the dorsum of the right hand were nondraining and erythematous. Instead, call the animal control office in your area. Kittens bite, mouth, and paw things to explore their worldthey're all natural behaviors. In most cases, bites that were positioned directly over the wrist or another joint were more likely to result in hospitalization than bites to soft tissue, the researchers said. Tetanus is a serious infection caused by a bacterium called Clostridium tetani. MeSH terms Adult Aged Dog or cat bites to the hands are the most severe injuries, often requiring surgical intervention and hospitalization.1 Infectious complications occur in approximately 50% of cat bites. These findings should increase concern for a severe infection and warrant hospitalization and urgent consultation with a hand surgeon. Another SOLID Site, WALANT | Wide Awake Local Anesthesia No Tourniquet. Follow-up evaluation should focus on early detection and diagnosis of tenosynovitis, septic arthritis, and osteomyelitis. According to a study in the New England Journal of Medicine, the average patient with a cat bite first noticed their infections about 12 hours after the bite. Wrist tendonitis is irritation and inflammation of the tendons at the wrist joint. If you know the cat thats bitten you has a rabies vaccine, its unlikely that youll contract rabies. However, more severe reactions can occur, and rashes can develop. The study, published in the February issue of the Journal of Hand Surgery, also revealed that eight patients needed more than one surgical procedure, and some needed reconstructive surgery. If you have a hand injury and would like to have it evaluated by our areas leading hand specialist, contact us today to schedule an appointment. The small but deep puncture wounds are. A prescription was given prophylactically for amoxicillin (Augmentin) 875 mg one orally b.i.d. Bethesda, MD 20894, Web Policies Data included patient demographics, anatomical site of injury, microbiology results, method of treatment and surgical outcome. This site is not intended to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. Do not allow kittens and young cats to play with your hands. It can be caused by overuse and repetitive movements like texting, playing video games, or writing. [Hyatt, 2017] Patients often present 2-5 days after an injury. 2005-2023 Healthline Media a Red Ventures Company. and transmitted securely. An initial assessment of early cellulitis and right-hand pain secondary to the cat bite and fall was made. 2022 Feb 23;14(5):867. doi: 10.3390/polym14050867. Victims should be especially concerned about the risk of a cat bite infection if they develop swelling or inflamed skin. However, play it safe by washing the area thoroughly with soap and water. In the Mayo Clinic study, eight of the 193 patients surveyed required more than one operation, and some had to have reconstructive surgery. Even though they dont look like much, a cats pinpoint bite marks can inject bacteria deeply into skin and joints, opening the door for a serious infection. Capillary refill to the upper extremities measured fewer than three seconds. All rights reserved. Medicine (Baltimore). Open cat bite of wrist; Open cat bite wound of neck; Present On Admission. Practical Review of the Management of Animal Bites. "The infection from the cat bite reached my tendon," Bothun said. Keywords: How do you know if a cat bite is infected? If you cant capture the cat, you might need to start rabies vaccination as a precaution. While 3-18 percent of dog bites become infected. The puncture hole can quickly seal over and trap bacteria from the cats mouth under your skin. What is the potential risk associated with cat bites? Polymer-Based Constructs for Flexor Tendon Repair: A Review. Minor injuries from family pets may lead to serious wounds, facial damage, and emotional problems. It is especially dangerous for a cat to bite the wrist or hand - all places where joints, bones and tendons are close to the surface. SUNDAY, Feb. 9, 2014 (HealthDay News) -- Cat bites may look less serious than dog bites, but beware: They can cause dangerous infections, particularly when they involve the hand, new research indicates. The 2023 edition of ICD-10-CM S61.451A became effective on October 1, 2022. Nerve injury: It's possible for the nerves to be damaged when a cat bites you. Clipboard, Search History, and several other advanced features are temporarily unavailable. While the kitten grabbing at your hand and biting your fingers may be adorable, it wont be so adorable anymore when he has grown into an adult cat. PMC Of these, 78% (n = 7) underwent multiple operations secondary to septic arthritis, osteomyelitis, necrotising fasciitis and deep collection. . doi: 10.7759/cureus.9357. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Additionally, cats' mouths carry a large number of bacteria which can cause serious infections in bite wounds. There is not very much bloodflow to the tendon sheath. COVID-19 Screening in the Pediatric Emergency Department. Symptoms include not only pain, but also numbness and paresthesia. 2006 Mar;31(3):468-73. doi: 10.1016/j.jhsa.2005.12.011. Nine patients (Group B) presented later than 48 hours. Misunderstanding this risk has led to a worrying number of hospitalizations, as patients require surgery to clean wounds or remove tissue thats become infected. Common pathogens include Pasteurella species, Staphylococcus aureus, streptococci, anaerobes, Capnocytophaga, Moraxella, Corynebacterium, and Neisseria. From furniture, scratching posts, beds and toys to food dishes and litter boxes, youll find everything you need for your feline family members.View the Product Guide. However, delayed presentation may lead to significant morbidity or even mortality. Keywords: Hand or wrist infection; cat bites; delayed treatment; diabetic finger; finger amputation; public awareness. for three to five days. J Am Acad Orthop Surg. Bacteria can be potentially seeded down into joints and tendon sheaths, far away from where it would be immediately noticed. Cat bites to the hand are so dangerous, 1 in 3 patients with such wounds had to be hospitalized, a Mayo Clinic study covering three years showed. One of the more common is a highly pathogenic bacterium, Pasteurella multocida. It was strongly advised that the patient follow up the next day, but Mr. H declined. While most bug bites cause only mild symptoms, some bug bites can transmit disease. 'The wrist is packed with tendons and blood vessels, so infection can be pumped to . I still have a small bump from a cat that bit my hand around twenty-five years ago. The .gov means its official. Identifying Bug Bites and Stings, and How To Treat Them. Not all cat bites lead to infection, but enough do to warrant caution. Preoperative Antibiotics Influence Culture Yield in the Treatment of Hand, Wrist, and Forearm Infections. 4th ed., Gainesville Fla.: Barmarrae Books; 2003. Cat-scratch disease in the United States, 20052013. A serious infection can develop 24-48 hours after being bitten. Signs and Symptoms Signs that your bite may be infected include: Swelling Redness Warmth Continued pain beyond 24 hours Drainage from the wound Signs that your infection may be spreading include: Red streaks up the arm or forearm Swollen glands around the elbow or in the armpit Fever Tiredness Night sweats Shakes Published in February in the Journal of Hand Surgery the study looked at 193 patients who received treatment for a cat bite on the hand from January 2009 through 2011. "When my grandkids come over I don't let him around them, because things happen.". Cureus. The trusted provider of medical information since 1899, Overview and Evaluation of Hand Disorders, Digital Flexor Tendinitis and Tenosynovitis (Trigger Finger), Last review/revision Apr 2022 | Modified Sep 2022. 2020 Jul 23;12(7):e9357. fever or chills. "We don't play like we used to," Bothun said. Bats are one of the most common carriers of rabies. Uphold CR, Graham MV. Cat bite: An unusual cause of foot drop. Careers. Results were negative for fracture, dislocation, and lytic or blastic lesions. - dog bite: - consider viridans strep, pasteurella multocida, bacteroides, fusobacterium, capnocytophaga; - prophylactic treatment: augmentin / amoxicillin or with allergy ( cipro + clindamycin) For 14 percent of these patients, outpatient treatment with antibiotics didn't work and they needed to be hospitalized. If you do get a cat bite, youll likely find out pretty quickly if its going to get infected. Type of study/level of evidence: Bookshelf There was limited range of motion at the PIP joint on the second digit. Rapidly Progressive Infection of Hand After a Cat Bite. Guidelines for the treatment of cat and dog bites in humans. Risk factors associated with hospitalization included smoking, immunocompromised state, and location of bite over a joint or tendon sheath. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. An infectious disease consultation was ordered. Patients with clenched fist injuries tend to wait hours or days after the wound occurs before seeking medical attention, which increases the severity of the infection. By joining Cureus, you agree to our Copyright 2023 Haymarket Media, Inc. All Rights Reserved Bliss 101 Registered User regular. Brandon P. Donnelly, MD When To Worry The wrist or any joint in the fingers are usually the worst places to be wounded - and that's just where most people get bitten by cats. If you dont know the rabies status of the animal, try to locate it and call animal control. Please login or register first to view this content. Dr. Kaul is the MSN and DNP Program Director and an associate professor at Concordia University Wisconsin in Mequon. Mr. H noted a progression of redness and swelling over the past three days, and admitted inconsistent use of the sling. Eleven patients (Group A) were presented within 48 hours of their injury. Occasionally an infection can cause tendinitis, especially infection from a cat or dog bite to the hand or a finger. A red area around a cat scratch or bite that continues to get bigger for more than 2 days after the injury. eCollection 2021 Sep. Strwald Y, Erdle B, Busch P, Kalbhenn J, Bansbach J. Anaesthesist. If the wound is deep, if you see signs of infection as listed above, or if you have any other reason for concern, be sure to see your doctor. Stay away from stray or feral cats. The more severe the bruising or bleeding looks, the worse the bite is. Time from bite to presentation, white blood cell count, erythrocyte sedimentation rate, and C-reactive protein values at presentation were not associated with hospitalization. Wrist tendinitis (tendonitis) is inflammation in the tendons that connect your lower arm to the bones in your fingers. The average of the participants was 49 years old, and 69 percent were women. Bookshelf All patients recently treated at our institution for cat bite injuries to the hand were retrospectively reviewed. Serious complications include infectious arthritis Acute Infectious Arthritis Acute infectious (septic) arthritis is a joint infection that evolves over hours or days. The type of animal involved will determine the specific injury that occurs; cats have a weaker bite but sharper teeth, therefore cause deep puncture wounds, whilst dogs have a strong bite . Lim JS, et al. Practical Review of the Management of Animal Bites. [Polymicrobial osteomyelitis on the limb of the hand after a cat bite]. On physical examination, BP was 118/80, pulse 106, respiratory rate 20 breaths per minute, temperature 99.9F, and pulse oxygenation 98%. Open wound of wrist, hand and fingers ( S61) S61.451A is a billable ICD-10 code used to specify a medical diagnosis of open bite of right hand, initial encounter. Clinical Guidelines in Family Practice. Sources: Babovic N, Carlsen BT, Cayci C. Cat Bite Infections of the Hand: Assessment of Morbidity and Predictors of Severe Infection. The patient was switched to cefuroxime (Ceftin) 500 mg b.i.d. If youre bitten by a stray, it may be necessary to capture the animal so it can be observed. Though cats are soft and cuddly, they may bite or scratch when theyre spooked. [Sepsis after cat bite-How medical history, physical examination and interdisciplinary cooperation influence disease progression]. If there is a lot of blood, apply pressure to stop the bleeding. Cats can also injure their tendons or ligaments slowly over time as a result of repetitive straining, overexertion, or fatigue. Infections occur as a result of a combination of the oral flora of the animal and the human skin flora. Read all about risks and treatment for a cat bite. The site is secure. During a bite, a cat's tooth might also transfer pathogens commonly found on human skin ( Staphylococcus and Streptococcus) into underlying tissues, creating a "cocktail" of bacterial contamination. Obviously, the best bite is the one that has been prevented. Adult cats bite out of fear, to assert dominance, or to demand attention. This includes bites that: [8] Are on the face sharing sensitive information, make sure youre on a federal Regardless of how a cat bite happens, it is not something to take lightly. A fever is considered a temperature of 100.4 degrees Fahrenheit or higher. loss of mobility in your finger or hand. Dawn Bothun, of Minnesota said a bite on her hand turned into an eight-week hospital ordeal and $150,000 in medical bills. You can contract cat scratch fever from cats infected with Bartonella henselae bacteria. A dogs powerful jaws and blunt teeth tend to leave a larger wound, but they dont penetrate as deeply. When a cat lands on the ground incorrectly after jumping, the ligaments and tendons are at risk of tearing, rupturing or breaking down over time. red streaks that run up your hand and arm. Tendons and ligaments in the hand are especially delicate. Pet owners must be made aware of the seriousness of a cat bite. With these locations, it's not hard for a cat to puncture a joint or the layer of membrane that covers a tendon. According to a 2018 research review, infection occurs in about 50 percent of cat bites in children. The fear is that bacteria from the person's skin or from the cat's or dog's mouth gains access to a part of the body that is like a freeway for the bacteria to spread quickly the tendons. S61.451A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. A doctor or nurse will wash the wound thoroughly, trim away any dead tissue, and apply antibiotic ointment. Check for signs such as bruising, punctured skin, bleeding, and objects stuck in the wound. Enechukwu AOM, Bucher F, Dastagir K, Jokuszies A, Vogt PM, Knneker S. Ann Med Surg (Lond). You love your cat. And of course, most of us will pet stray cats we meet along the way, but not all seemingly friendly cats remain friendly after being approached by strangers. Can Vitamin D affect your risk of heart disease? Cat bite - what to do? Diagnosis of Ligament and Tendon Conditions in Cats Would you like email updates of new search results? 2023 USA TODAY, a division of Gannett Satellite Information Network, LLC. Ms. Henderson is a family nurse practitioner at Wheaton Franciscan HealthcareAll Saints in Racine, Wisc. The list above outlines the symptoms of an infected bite. The skin usually flaps over the bite, thereby sealing off . Human and other mammalian bite injuries of the hand: evaluation and management. Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JL. Dog and cat bites to the hand: treatment and cost assessment. One study in the New England Journal of Medicine estimated that 63% of cat bites were on the patients hands, followed by the arm with 23% of bites. The information shared in this article is not a substitute for medical care. Epub 2022 Jul 20. Additionally, cats mouths carry a large number of bacteria which can cause serious infections in bite wounds. Felines' sharp teeth can inject harmful bacteria deep into joints and tissue, doctors warn. INTRODUCTION. Here's what you need to know. Report of 34 cases and review of the literature. He said people tend to ignore cat bites because they are so small, but they can lead to a laundry list of medical treatments. A three-year Mayo Clinic study of nearly 200 cases between 2009-2011 found that one third of patients suffering from cat bite infections were hospitalized and two-thirds of those patients required surgery. We recommend that any symptomatic cat bites to the upper limb, especially hand and wrist, must be treated promptly, essentially within 48 hours of injury, particularly in immunocompromised population. Because cat bites usually cover a small area, you will probably be able to cover it with an over-the-counter adhesive Band Aid. The treatment of such infections often requires hospitalization, intravenous antibiotic therapy, and operative treatment. Dog or cat bites to the hands are the most severe injuries, often requiring surgical intervention and hospitalization.1 Infectious complications occur in approximately 50% of cat bites whereas with dog bites, the overall estimated infection rate is 2% to 20%. Immunocompromised people are at a higher risk of developing a severe infection from these bacteria. Published by: Ingrid King. Some bites require the use of antibiotics through an intravenous (IV), while others may be treated with oral medication. The subjects were 18 females and two males aged 27-86 years (mean age of 58 years). Mr. H returned in three days as instructed. The bacteria injected by a cat bite can include a strain common in animals and particularly hard to fight with antibiotics, he says. Infections of Deep Hand and Wrist Compartments. Of those admitted to the hospital, 38 patients needed surgery to clean the wound or remove infected tissue. 2017 Dr. Brandon P. Donnelly Cat bite injuries to the hand can progress to serious infection. He is currently an Assistant Professor of Orthopedic Surgery at Louisiana State University (LSU) Health Sciences Center. We recommend that any symptomatic cat bites to the upper limb, especially hand and wrist, must be treated promptly, essentially within 48 hours of injury, particularly in immunocompromised population. If a cat hasnt been vaccinated for rabies, contact a doctor to decide if you need treatment known as rabies postexposure prophylaxis (PEP). Treatment of hand infections using WALANT -when the anesthesiologist is not available: A retrospective cohort study. "They can be very serious. At six-weeks postoperative, Mr. H had full range of motion and increased strength in the right hand. Tenderness along the course of a tendon suggests spread to the tendon sheath. Felines' sharp teeth can inject harmful bacteria deep into joints and tissue, doctors warn SUNDAY, Feb. 9, 2014 (HealthDay News) -- Cat bites may look less serious than dog bites, but beware: They can cause dangerous infections, particularly when they involve the hand, new research indicates. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. The right arm was placed in a sling for elevation of the extremity. You may need to be on antibiotics so get medical care. When the injury has occurred, wash the wound with soap and then apply antiseptics. Dog and cat bites to the hand: treatment and cost assessment. . Empiric antibiotics for outpatient treatment usually include monotherapy with amoxicillin/clavulanate 500 mg orally 3 times a day or combined therapy with penicillin 500 mg orally 4 times a day (for E. corrodens, P. multocida, streptococci, and anaerobes) plus either a cephalosporin (eg, cephalexin 500 mg orally 4 times a day) or semisynthetic penicillin (eg, dicloxacillin 500 mg orally 4 times a day) for staphylococci.

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