Bite

# Overview
A bite is a wound received from the mouth (and in particular, the teeth) of an animal or person. Most animal bites are from dogs or cats, and the pathogens in the wound are composed by the normal oral flora of the biting animal and human skin flora.
Animals may bite in self-defense, in an attempt to predate food, as well as part of normal interactions. Other bite attacks may be apparently unprovoked, especially in the case of bites committed by psychologically or emotionally disturbed humans. Some disorders such as Lesch-Nyhan syndrome may cause people to bite themselves.
Bite wounds can be very complex and it is important to address the following aspects:
- Generalized tissue damage due to tearing and scratching.
- Serious hemorrhage if major blood vessels are pierced.
- Infection by bacteria or other pathogens, including rabies.
- Introduction of venom into the wound by venomous animals such as some snakes.
- Introduction of other irritants into the wound, causing inflammation and itching.

# Common Pathogens
Almost every bite will have a polimicrobial contamination and some bites have characteristic pathogens associated to the oral flora of the animal that bit.

# Treatment
- All bite wounds should be cleaned profusely with iodide soap and water.
- Bites are contaminated by a polimicrobial flora and antibiotic prophylaxis treatment is recommended to avoid subsequent infection.
- The route of administration depends on the depth and severity of the wound, as well as the time that has passed since the bite.

## Antibiotic TherapyAdapted from Guidelines for Skin and Soft-Tissue Infections CID 2005
 Click on the following categories to expand treatment regimens.

# Vaccination

## Tetanus Prophylaxis Adapted from CDC Vaccines and Immunizations - Tetanus 
The need for active immunization, with or without passive immunization, depends on the condition of the wound and the patients immunization history.
The following table summarizes the indications for tetanus prophylaxis.

## Rabies Prophylaxis Adapted from CDC - ACIP Recommendations for postexposure prophylaxis (PEP) to prevent human rabies.
Animal bites inflicted by carnivores (except rodents) are considered possible cases of rabies. The animal is caught alive or dead with its head preserved, so the head can later be analyzed to detect the disease.
If the animal lives for ten days and does not develop rabies, then it is probable that no rabies infection has occurred.
If the animal is gone, prophylactic rabies treatment is recommended.
Signs of animal rabies include:
- Foaming at the mouth
- Self-mutilation
- Growling
- Jerky behavior
- Red eyes.
 Click on the following categories to expand prophylactic regimens.

# Post Exposure Measures

## Minor wounds
- Wash the wound thoroughly with soap and water.
- Apply an antibiotic cream.
- Cover the wound with a clean bandage.
- See a healthcare provider if the wound becomes red, painful, warm, or swollen; if you develop a fever; or if the dog that bit you was acting strangely.

## Deep wounds
- Apply pressure with a clean, dry cloth to stop the bleeding.
- If you cannot stop the bleeding or you feel faint or weak, call 911 or your local emergency medical services immediately.
- See a healthcare provider as soon as possible.

# See Also
- Snakebite
- Spider bite
- Wilderness first aid
- Insect bites and stings