Manual of Childhood Infections: The Blue Book (3 edn)
Annotate
Cite
Extract
see also Chapters 38, 39, 48, 105, 106
Bites
...
Incidence
...
Principles of management of bites
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History
A history must be taken that includes any bleeding tendency, underlying immunosuppression or deficiency in making a competent immune response. This includes a history of diabetes or steroid therapy, liver disease or functional asplenia.
Immunization status including tetanus status must be documented and if required, booster vaccines administered. The mechanism must be determined and the possibility of non-accidental injury considered; if there is concern, safe guarding procedures should be activated.
Examination
The location of the bite, its appearance, and if there is any associated damage to structures at the bite site, for example, tendons, nerves, joints, blood vessels, or involvement of any organs such as the eye, must be documented and acted upon.
The clenched fist also has the potential for the metapharyngeal space to be breached by a bite which can lead to osteomyelitis, septic arthritis, or tracking infections within synovial sheaths.
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