Podcast
Questions and Answers
What is the recommended treatment for a Cat-Scratch disease lymphadenitis?
What is the recommended treatment for a Cat-Scratch disease lymphadenitis?
What is the recommended antibiotic therapy for a Capnocytophaga infection?
What is the recommended antibiotic therapy for a Capnocytophaga infection?
What is the recommended tetanus prophylaxis for a clean and minor wound with previous doses of tetanus toxoid containing vaccine?
What is the recommended tetanus prophylaxis for a clean and minor wound with previous doses of tetanus toxoid containing vaccine?
What is the recommended antibiotic therapy for a more serious Cat-Scratch disease infection?
What is the recommended antibiotic therapy for a more serious Cat-Scratch disease infection?
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What is the recommended post-exposure prophylaxis for wound management?
What is the recommended post-exposure prophylaxis for wound management?
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What is the recommended antibiotic therapy for a Pasteurella multocida infection?
What is the recommended antibiotic therapy for a Pasteurella multocida infection?
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What percentage of emergency department visits are due to animal bites?
What percentage of emergency department visits are due to animal bites?
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What is the most common type of animal bite?
What is the most common type of animal bite?
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What is the median time to signs and symptoms of infection following a dog bite?
What is the median time to signs and symptoms of infection following a dog bite?
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What is characteristic of Pasteurella multocida infection?
What is characteristic of Pasteurella multocida infection?
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Where do cat bites tend to occur?
Where do cat bites tend to occur?
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What is the median time to signs and symptoms of infection following a cat bite?
What is the median time to signs and symptoms of infection following a cat bite?
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What type of wounds require surgical consultation?
What type of wounds require surgical consultation?
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What is the preferred antibiotic for prophylaxis in wound management?
What is the preferred antibiotic for prophylaxis in wound management?
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What is the recommended duration of prophylactic oral antibiotics?
What is the recommended duration of prophylactic oral antibiotics?
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When is surgical consultation indicated for infected wounds?
When is surgical consultation indicated for infected wounds?
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What is the preferred antibiotic for empiric (parenteral) therapy?
What is the preferred antibiotic for empiric (parenteral) therapy?
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What should antibiotic therapy be tailored to when available?
What should antibiotic therapy be tailored to when available?
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Study Notes
Animal Bites and Infections
- Approximately 2 to 5 million animal bites occur annually, accounting for 1% of emergency department visits and 10,000 inpatient admissions annually.
- Dog bites account for 90% of animal bites, while cat bites account for 10%.
- In children, dog bites often involve the head and neck, while in adolescents and adults, they usually involve the extremities.
- Cat bites typically occur on the extremities and tend to penetrate deeply, resulting in a higher risk of deep infection.
Pasteurella Multocida Infections
- Characterized by rapid development of an intense inflammatory response within 24 hours of the initial injury.
- Symptoms include pain, swelling, purulent drainage, lymphangitis, and regional lymphadenopathy.
- Definitive therapy: Penicillin G, Amoxicillin-clavulanate, Cefuroxime, or Ciprofloxacin.
Capnocytophaga Infections
- Definitive therapy: Piperacillin-tazobactam or Imipenem.
Cat-Scratch Disease
- Definitive therapy for lymphadenitis: Azithromycin (500 mg PO on day 1, followed by 250 mg PO for four days).
- Definitive therapy for more serious infections: Rifampin (300 mg PO/IV twice daily) plus azithromycin (500 mg PO/IV on day 1, followed by 250 mg PO/IV daily), both administered for 10 to 14 days.
Tetanus Prophylaxis
- Wound management and tetanus prophylaxis are necessary for all wounds.
- Tetanus toxoid-containing vaccine is recommended for all wounds, with additional Human Tetanus Immune Globulin (HTIG) for certain wounds.
Rabies Prophylaxis
- Rabies prophylaxis is necessary for all animal bites.
Management of Animal Bites
- Antibiotic prophylaxis is indicated for:
- Lacerations undergoing primary closure and wounds requiring surgical repair.
- Wounds on the hand(s), face, or genital area.
- Wounds in close proximity to a bone or joint.
- Wounds in areas of underlying venous and/or lymphatic compromise.
- Wounds in immunocompromised hosts (including diabetes).
- Deep puncture wounds or laceration (especially due to cat bites).
- Wounds with associated crush injury.
- Preferred antibiotic prophylaxis: Amoxicillin-clavulanate 875/125 mg twice daily or alternative agents.
- Duration of prophylactic oral antibiotics is three to five days with close follow-up.
Surgical Consultation
- Indicated for:
- Complex facial lacerations.
- Deep wounds that penetrate bone, tendons, joints, or other major structures.
- Wounds associated with neurovascular compromise.
- Infections involving the hands or face.
- Infections associated with neurovascular compromise.
- Presence of crepitus.
- Persistent signs and symptoms of infection despite appropriate antibiotic therapy.
- Debridement.
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Description
This quiz covers the definitive therapy for various bacterial infections, including Pasteurella multocida and Capnocytophaga infections, as well as Cat-Scratch Disease, including the antibiotic regimens and dosages.
