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    Friday, June 26, 2009

    Recommendations on Managing Infection Passed from Pets to Humans via Bite Injuries

    Life-threatening pathogens including the very dangerous MRSA can be transmitted from cats and dogs to humans via bite wounds — and such injuries should prompt careful clinical consideration.

    Among the pet-related pathogens are Pasteurella, Capnocytophaga, Streptococcus, and Staphylococcus species — with methicillin-resistant Staphylococcus aureus on the rise. Given the potential for severe complications, the authors offer a wound management strategy. Steps include:

    • Culture for aerobes and anaerobes if the patient has an abscess, severe cellulitis, devitalized tissue, or sepsis.

    • Irrigate the wound with saline solution.

    • Order radiographs in case of fracture or bone penetration; MRI or CT may also be indicated.

    • Prescribe prophylactic antibiotics as necessary. If MRSA is suspected, first-line antibiotics include trimethoprim-sulfamethoxazole, doxycycline, minocycline, and clindamycin.

    • Hospitalize the patient if there is fever, sepsis, spreading cellulitis, severe edema, crush injury, or loss of function, or if the patient is immunocompromised or likely to be nonadherent.

    * Tune in tomorrow for falsified data on sleep apnea in severely obese patients.

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