Emergency Medicine 46 years experience. The index finger was the most common site of injury (45%). 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. He is currently an Assistant Professor of Orthopedic Surgery at Louisiana State University (LSU) Health Sciences Center. Most domestic cats are already vaccinated against rabies. Acute Hand Infections | AAFP Of these, 78% (n = 7) underwent multiple operations secondary to septic arthritis, osteomyelitis, necrotising fasciitis and deep collection. Active range of motion deficits are present at the wrist and thumb due to pain and swelling. You may need to begin rabies treatment if the cat thats bitten you shows any rabies symptoms. Copyright 2023 Haymarket Media, Inc. All Rights Reserved Clinical findings suggestive of the need for hospitalization include location of the bite over a joint or tendon sheath, erythema, pain, and swelling. ", "It can be just a pinpoint bite mark that can cause a real problem," he said, "because the bacteria get into the tendon sheath or into the joint where they can grow with relative protection from the blood and immune system.". Am Fam Physician. In more extreme cases, redirected aggression can cause a cat to lash out at her guardian and cause severe damage. The treatment of such infections often requires hospitalization, intravenous antibiotic therapy, and operative treatment. Giant Cell Tumor of Tendon Sheath in Guyon's Canal Causing Ulnar Tunnel Syndrome . Two thirds of those hospitalized during the study required surgery to flush out the infection in the wounds and middle-aged women were the most common bite victims. PMC . Tendon necrosis and rupture; Hand dysfunction; Amputation; Systemic infection ~75% of cases are associated with antecedent injury. 2006;31:468-473. Skin infections, known as cellulitis, can occur quickly after a bite. Wrist Tendonitis; DeQuervain's Tendonitis; Carpal Boss; Wrist Fractures; Distal Radius Fracture of the Wrist; Scaphoid Fractures of the wrist . Data included patient demographics, anatomical site of injury, microbiology results, method of treatment and surgical outcome. Before joining Pontchartrain Orthopedics and Sports Medicine, he completed a hand and microsurgery fellowship at the prestigiousPhiladelphia Hand Center. Symptoms include not only pain, but also numbness and paresthesia. 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. Rapidly Progressive Infection of Hand After a Cat Bite. sharing sensitive information, make sure youre on a federal National Library of Medicine Its not something you want to take any chances with. J Hand Surg Am. "Dogs' teeth are blunter, so they don't tend to penetrate as deeply and they tend to leave a larger wound after they bite," study senior author Dr. Brian Carlsen, a Mayo Clinic plastic surgeon and orthopedic hand surgeon, said in a clinic news release. Painful and swollen lymph nodes for more than 2 or 3 weeks. Guidelines for the treatment of cat and dog bites in humans. One of the more common is a highly pathogenic bacterium, Pasteurella multocida. "Every time they would stitch me up after flushing the wound the infection would just get worse. She said because she was uninsured the hospital wrote off some of the bill but she is still making payments. Victims should be especially concerned about the risk of a cat bite infection if they develop swelling or inflamed skin. (2014). 2019 Dec;53(6):341-346. doi: 10.1080/2000656X.2019.1637750. Mr. H was advised to stop taking Vicodin and started on oxycodone (Percocet) 5/325 mg one or two orally every six hours as needed. Cat bites are typically puncture wounds that penetrate deeply into the skin and underlying tissues [2] with infection rates of up to 50% [4]. You can contract cat scratch fever from cats infected with Bartonella henselae bacteria. If you notice any redness, swelling, discharge from the wound, increasing pain, or difficulty moving the hand, seek emergency care. Cat bites need to be taken seriously and carefully evaluated by doctors, the study authors said. (2016). Unlike other animal bites, which can tear flesh and even break bones, these deeper wounds are much harder to clean. Here are some of the potential infectious diseases that can happen after a cat bite: Pasteurella multocida is a type of bacteria frequently found in the mouths of cats that can cause infections after a bite or scratch. Cat bites are serious! But if an unvaccinated cat has bitten you, you must take the bite seriously. of dog bites, middle-aged women were the most common victims of cat bites to the hand, according to the Mayo Clinic study. We cannot answer questions about whether your bite needs medical attention in the comments section. Treatment of infected bite wounds of the hand includes surgical debridement, with the wound left open, and antibiotics. The patient was able to return to work. If the wound is bleeding, dont stop blood flow; in fact, try to encourage bleeding by gently pressing the area around the wound. Signs and symptoms warranting earlier evaluation (e.g., fever, chills, increasing edema, erythema, numbness, drainage, and pain) were discussed. 8600 Rockville Pike A peripherally inserted central catheter line was placed and IV ceftriaxone (Rocephin) administered. Before SEE MORE: Symptoms of Infected Cat Bite and Steps To Take For A Cat Bite. Diabetic fingers with established peripheral neuropathy were more likely to undergo amputation. Sources: Babovic N, Carlsen BT, Cayci C. Cat Bite Infections of the Hand: Assessment of Morbidity and Predictors of Severe Infection. HHS Vulnerability Disclosure, Help Can Vitamin D affect your risk of heart disease? We avoid using tertiary references. In the Mayo Clinic study, eight of the 193 patients surveyed required more than one operation, and some had to have reconstructive surgery. Epub 2021 Jul 2. Their razor-sharp teeth and nails can puncture deeply, sometimes penetrating tissues, ligaments and tendons. (2021). Healthline Media does not provide medical advice, diagnosis, or treatment. Conscious Cat is reader-supported. If you have been bitten by a cat, seeyour doctor or visit anurgent care facility. It was strongly advised that the patient follow up the next day, but Mr. H declined. If there is a lot of blood, apply pressure to stop the bleeding. Cat-Scratch Disease: Causes, Prevention, and Treatment - familydoctor.org You love your cat. Carlsen said the lesson is that people need to be careful of cat bites and monitor them for swelling and redness. Some people need surgery, though. A doctor will decide if the wound needs stitches or surgery to heal properly. Patient demographics, medical history, physical examination findings, laboratory values, and long-term follow-up data were collected. When a cat bites, it may not seem like a big deal it can be cute when theyre playing but some cat bites can pose significant health risks. 4th ed., Gainesville Fla.: Barmarrae Books; 2003. Dry the bite first, to help the Band Aid stick. Dog and cat bites to the hand: treatment and cost assessment. Ms. Henderson is a family nurse practitioner at Wheaton Franciscan HealthcareAll Saints in Racine, Wisc. At the hand, where cats most often bite . Cat bites are more frequent in the mornings, in the summer, and in spring [4]. Mr. H. was then sent for immediate orthopedic surgical evaluation. 2023 ICD-10-CM Diagnosis Code S61.451A: Open bite of right hand Cat bite: treatment, risks, complications - hillsteaddental.com In almost all states, a cat that has bitten a human or another domestic animal must undergo a mandatory 10-day quarantine period. Keywords: Mr. H was diagnosed with a septic joint, scheduled for incision and drainage, and admitted to the hospital overnight for observation. Although the diagnosis of infected bite wounds of the hand is clinical, x-rays should be taken to detect fracture or teeth or other foreign bodies that could be a nidus of continuing infection. Dutton LK, Hinchcliff KM, Logli AL, Mallett KE, Suh GA, Rizzo M. JB JS Open Access. Cats can also injure their tendons or ligaments slowly over time as a result of repetitive straining, overexertion, or fatigue. Small but deep punctures there led to a higher risk of hospitalization than bites into soft tissue, according to the study. Infected Bite Wounds of the Hand - Musculoskeletal and Connective If you decide to delay medical care, watch closely for signs of infection. Though these injuries are typically not life-threatening. Unauthorized use of these marks is strictly prohibited. If the bite or scratch hasn't penetrated the skin, the chance of infection is minimal. 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. Stay away from stray or feral cats. 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. Kheiran A, Palial V, Rollett R, Wildin CJ, Chatterji U, Singh HP. You should also teach children how to properly handle pets and to make sure they arent doing anything to unintentionally hurt or scare a cat. With these locations, it's not hard for a cat to puncture a joint or the layer of membrane that covers a tendon. eCollection 2022 Jan-Mar. All rights reserved. Osteomyelitis following domestic animal bites to the hand: Two case reports and practical guidelines. Another SOLID Site, WALANT | Wide Awake Local Anesthesia No Tourniquet. As for Mr. Bink's, she said they are still on good terms, but things have changed. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Give them time to calm down before approaching them. (2016). The pain almost drove me up the . The patient appeared ill and uncomfortable. Cat bite: an injury not to underestimate. Unauthorized use of these marks is strictly prohibited. Clinical Guidelines in Family Practice. Camacho Zamora P, Romn Cabello M, lvarez Garca P, Vzquez Canal E. Rev Esp Quimioter. Sbai MA, et al. Pasteurella multocida infections. While most bug bites cause only mild symptoms, some bug bites can transmit disease. Can taking antioxidants protect you against cancer? This means that the cat's saliva has a chance to enter the sealed-off areas of joints and tendons, which make a prime breeding ground for the . Handchir Mikrochir Plast Chir. Infectious tenosynovitis - UpToDate Purpose: Two-third of those hospitalized needed surgery. These include: If the cat bite is deep, it can damage your tendon(s). A recent Mayo Clinic study shows that one out of three people who sought treatment for a cat bite to the hand were hospitalized. I still have a small bump from a cat that bit my hand around twenty-five years ago. How long after a cat bite does infection set in? in New Orleans, where he was awarded the Orthopedic Surgery award. 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. (See also Overview and Evaluation of Hand Disorders Overview and Evaluation of Hand Disorders Common hand disorders include a variety of deformities, ganglia, infections, Kienbck disease, nerve compression syndromes, noninfectious tenosynovitis, and osteoarthritis. Cat bites and scratches: Sometimes more than just a cut. While 3-18 percent of dog bites become infected. Disclaimer. Tendons can rupture and may require surgery. Instead, call the animal control office in your area. Careers. We identified 193 patients in a 3-year period between January 1, 2009, and December 31, 2011. Immunocompromised people are at a higher risk of developing a severe infection from these bacteria. The skin on the second digit of the right hand showed significant edema and erythema circumferentially (Figure 1). Cat bites to the hand can be especially dangerous since tendon sheaths and joints are close to the surface in the hand and cat bites penetrate deeply. Bliss 101 Registered User regular. - The management of bite wounds in children--A retrospective analysis at a level I trauma centre . Millions of people are bitten by animals every year. Recovery could take four to six months. The 2023 edition of ICD-10-CM S61.451A became effective on October 1, 2022. There is no such thing as a simple cat bite, yet most patients are unaware of the potential for harm, and they delay or fail to seek immediate evaluation and treatment. The warm and dark inner layers of your skin are optimal for the growth of the bacteria. Cureus | Rapidly Progressive Infection of Hand After a Cat Bite "Cats' teeth are sharp and can penetrate very deeply. Review: The Cat in the Window And Other Stories of the Cats We Love. (2015). 1984 May;63(3):133-54. Bacteria can be potentially seeded down into joints and tendon sheaths, far away from where it would be immediately noticed. In cat bite wounds, they are followed by Streptococci, Staphylococci, Neisseria and Moraxella spp. Is It Bedbugs, Other Bug Bites, or a Rash? Pulling away, Mr. H fell back and landed on a coffee table with his open right hand hyperextended. While some cat bites may heal without causing infection, it is recommended that you seek medical attention for all cat bites. MeSH terms Adult Aged At the initial visit, Mr. H was alert and oriented. In todays blog post, Dr. Brandon P. Donnelly discusses why the risk of a cat bite infection has become a growing concern. The patient was switched to cefuroxime (Ceftin) 500 mg b.i.d. Cat Bite Injuries to Humans | VCA Animal Hospital Complications were common among these patients. 2022 Dec 16;55:e0372-2022. Practical Review of the Management of Animal Bites. It has to pierce deep enough to get into the muscle where there is a good amount of blood flow. Are cat bites and cat scratches really that scary? : r/cats - reddit Misunderstanding this risk has led to a worrying number of hospitalizations, as patients require surgery to clean wounds or remove tissue thats become infected. A. 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. Federal government websites often end in .gov or .mil. This includes bites that: [8] Are on the face Dawn Bothun, of Minnesota said a bite on her hand turned into an eight-week hospital ordeal and $150,000 in medical bills. Noninfected bite wounds may require surgical debridement and prophylaxis with 50% of the dose of antibiotic used to treat infected wounds. Created for people with ongoing healthcare needs but benefits everyone. 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Enter search terms to find related medical topics, multimedia and more. Pet owners must be made aware of the seriousness of a cat bite. Dr. Donnelly is a board certified orthopedic surgeon specializing in injuries and ailments of the hand, wrist, and elbow. Privacy Policy eCollection 2021 Sep. Malizos KN, Papadopoulou ZK, Ziogkou AN, Rigopoulos N, Athanaselis ED, Varitimidis SE, Dailiana ZC. Discomfort. The family cat lunged at him and bit and scratched his hand. Infection is the consequence of cat bites that medical professionals are most worried about. Protected from the immune system, a cat bite infection can rapidly spread. When you buy via links on our site, we may earn an affiliate commission at no cost to you. Animal Bite on Finger: Symptoms, Diagnosis & Treatment Options - Healthline Animal Bites - Orthopedic Specialists of Seattle The skin was warm and dry to touch. However, play it safe by washing the area thoroughly with soap and water. Cleveland's Most Fascinating Medical Stories: How Does a Cat Bite Turn It's the worst animal in the UK to be bitten by. Part 2 Seek Medical Care for Severe Bites 1 Go to the doctor if your bite is too serious for you to care for it adequately. Cat bite: An unusual cause of foot drop. According to the Centers for Disease Control and Prevention (CDC), there are only 1 to 3 cases in the United States each year. Nearly 40% of cat bites may lead to an infection according to one estimate, which supports the extra attention medical professionals often pay to cat bites. 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%. Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JL. Cat bite injuries to the hand can progress to serious infection. 1. It can be caused by overuse and repetitive movements like texting, playing video games, or writing. Please note that by doing so you agree to be added to our monthly email newsletter distribution list. for three to five days or one double-strength trimethoprim/sulfamethoxazole tablet b.i.d. Infections occur as a result of a combination of the oral flora of the animal and the human skin flora. Dawn Bothun, of Minnesota said a bite on her hand turned into an eight-week hospital ordeal and $150,000 in medical bills. Mr. H was discharged the next day and told to return to the infusion center every day for the next two weeks for IV Rocephin. 20 . The pain was markedly worse during second-digit flexion attempts or when pressure was applied. 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. Tendons And Ligaments In The Hand Are. This virus is almost always fatal when untreated, but its extremely rare. . MeSH BP was 120/78 mm Hg, pulse 98 beats per minute, pulse oxygenation 97%, temperature 98.8F, and weight 290 lbs. You should still clean the wound area with soap and water, but its unlikely you will have to take any action. any link with venom from cat bite affecting central nervous system? Would you like email updates of new search results? cat bite hand cellulitis lymphangitis hand infection. Mr. H, age 45 years, presented to the clinic following a cat bite to his right hand 14 hours prior. Learn about symptoms in cats and humans, and get facts on. What to do? Bite Wounds : Wheeless' Textbook of Orthopaedics Around 2% of attendances in the emergency department are due to bite injuries, most commonly from dogs, cats, and humans.If left untreated, bites have a high risk of becoming infected.. A red area around a cat scratch or bite that continues to get bigger for more than 2 days after the injury. cat bites Pasteurella (most common, 70-80% of cat bite infections) Pasteurella multocida and Pasteurella septica causes intense pain, swelling in 48h other organisms similar to dog bites Associated conditions secondary bacterial infection most bites do not become infected risk factors for infection bite to hand, foot, or major joint Bula-Rudas FJ, et al. The list above outlines the symptoms of an infected bite. 2006 Nov-Dec;106(6):692-5. doi: 10.1080/00015458.2006.11679983. The wrist or any joint in the fingers are usually the. 'A cat bite is much worse than a dog or rat bite.