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Zumla Alimuddin MRCP Phd
Current Opinion in Infectious Diseases: October 1991
Skin and soft tissue infections: PDF Only

Animal and human bite wounds commonly present to accident and emergency departments worldwide. Breach in the integrity of skin by bites results in the inoculation of a multitude of organisms from the skin of the victim and the oral cavities of the aggressor. Infection by unusual and potentially lethal zoonotic pathogens can easily by overlooked. Apart from local wound infection and surrounding cellulitis, fatal septicemia can follow minor bites, sometimes manifesting even after the wound has healed. While there is consensus of opinion on the treatment strategy of established bite wound infection, disagreement surrounds the management of minor noninfected wounds. The use of prophylactic antibiotics in the management of uninfected animal bite wounds remains a prominent contentious issue. Second and third degree burn injury disrupts the anatomic skin barrier and is known to be associated with disturbances in host immune responses. As a consequence, burn wounds are particularly susceptible to microbial colonization and infection from skin and environmental organisms. Although progress in the overall management of burns continues to improve morbidity and mortality, microbial sepsis remains one of the major threats to survival in burn patients. Burn wound infection with its local and systemic complications remains a serious management problem. Since there is paucity of data on many specific management issues, empiric prophylaxis and treatment protocols based on logical assumption are now well established. Several controversial issues relating to the management of bite wounds and the management and microbiology of burn wound infections are discussed in this review.

© Lippincott-Raven Publishers.