bite wound

咬伤
  • 文章类型: Case Reports
    背景:慢性胸骨骨髓炎是猫科动物的罕见疾病,迄今为止报告的病例有限。
    目的:我们报告一例2岁男性阉割,家养短毛猫,重4.68公斤,每3-4个月出现一次皮肤开口,尽管皮肤清创和重建。
    方法:检测到大于皮肤缺损的皮下死区。血液学分析显示炎症标志物水平升高。胸部X线检查显示胸骨变形和可疑骨髓炎。计算机断层扫描显示瘘管从第三个延伸到第四个胸骨。
    结果:骨和软组织清创和脓肿冲洗在长期抗生素治疗的同时进行。猫在手术后18个月的随访期内保持无复发。
    结论:据我们所知,这是在猫的胸骨上发生的慢性骨髓炎的第一个报告,代表了它的治疗的第一个成功案例。该病例显示了在类似病例中改善治疗结果的潜力。了解和成功治疗此类病例可以为更好地治疗猫骨髓炎铺平道路。
    Chronic sternal osteomyelitis is a rare condition in felines, with limited reported cases to date.
    We report the case of a 2-year-old castrated male, domestic shorthair cat, weighing 4.68 kg, that presented with skin openings every 3-4 months, despite skin debridement and reconstruction.
    A subcutaneous dead space larger than the skin defect was detected. Haematological analysis revealed elevated levels of inflammatory markers. Thoracic radiography revealed sternal deformation and suspected osteomyelitis. Computed tomography revealed a fistula extending from the third to the fourth sternebrae.
    Bone and soft tissue debridement and abscess flushing were performed along with long-term antibiotic therapy. The cat remained recurrence-free throughout an 18-month post-surgery follow-up period.
    To the best of our knowledge, this is the first report of chronic osteomyelitis occurring in a cat\'s sternebrae and represents the first successful case of its treatment. This case showcases the potential for improved treatment outcomes in similar cases. Understanding and successful treatment of such cases can pave the way for better management of feline osteomyelitis.
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  • 文章类型: Case Reports
    我们在急诊科遇到的大部分咬伤都是由狗造成的,猫和人类,但是咬伤可能是由各种动物造成的。这里,我们描述了一个由体重超过170公斤的大型大猩猩(西部低地大猩猩)引起的咬伤和创伤的案例。大猩猩咬伤很少见,除了多处咬伤外,患者的右远端radioulna开放性骨折。治疗需要仔细考虑大猩猩的抗原性,并进行文献综述以指导选择合适的抗微生物剂。此外,大型动物造成的创伤往往需要进行系统性创伤筛查,患者可能会因为害怕再次受到攻击而患上急性应激障碍;因此,早期精神干预很重要。
    The majority of bite wounds that we encounter in the emergency department are caused by dogs, cats and humans, but bite injuries can be caused by a variety of animals. Here, we describe a case of bite wound and trauma caused by a large gorilla (Western lowland gorilla) weighing over 170 kg. Gorilla bites are rare, and the patient had an open fracture of the right distal radioulna in addition to multiple bite wounds. Treatment required careful consideration of gorilla antigenicity and a literature review to guide the selection of appropriate antimicrobial agents. Furthermore, trauma inflicted by large animals tends to require systemic traumatological screening, and patients can develop acute stress disorder because of a fear of being attacked again; therefore, early psychiatric intervention is important.
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  • 文章类型: Case Reports
    未经证实:人类周围咬伤很少严重,通常需要医学治疗,最复杂的病例只需要轻微截肢或切除感染部位。很少有报告记录化脓性腱鞘炎的发展,坏死性筋膜炎,和这些病变的骨髓炎。在这些情况下,很少需要进行大截肢。
    未经证实:一名71岁的妇女在自己咬伤左手中指后出现不受控制的感染。病变的细菌培养显示耐甲氧西林金黄色葡萄球菌(MRSA)。感染无法通过抗生素或其他干预措施来控制。包括清创和轻微截肢。她在医院期间感染了严重的COVID-19,这限制了可用的治疗选择。为了控制感染,患者最终接受了左前臂远端大截肢.在从手术中恢复时,患者死于感染性休克和心肺骤停。
    未经评估:这种情况的异常进展可能归因于治疗急性COVID-19所需的干预措施以及多种混杂因素。例如,用于治疗重症患者的血管加压药和类固醇会损害对急性细菌感染的局部和全身生理反应。重要的是在大流行期间重新考虑临床期望,并尽早进行干预,以防止持续的损害和临床恶化。
    UNASSIGNED: Peripheral human bite wounds are rarely serious and are typically treated medically, with the most complex cases requiring only minor amputation or excision of the infected site. There are few to no reports documenting the development of purulent tenosynovitis, necrotizing fasciitis, and osteomyelitis from these lesions. Major amputations are required only rarely in these cases.
    UNASSIGNED: A 71-year-old woman presented with an uncontrolled infection following a self-inflicted bite wound to her left middle finger. A bacterial culture of the lesion revealed methicillin-resistant Staphylococcus aureus (MRSA). The infection could not be controlled with antibiotics or additional interventions, including debridement and minor amputation. She contracted severe COVID-19 while in the hospital which limited the available treatment options. In an attempt to control the infection, the patient ultimately underwent a major amputation of the distal left forearm. While recovering from the procedure, the patient succumbed to septic shock and cardiopulmonary arrest.
    UNASSIGNED: The unusual progression of this case may be attributed to the interventions required to treat acute COVID-19 as well as a variety of confounding factors. For example, vasopressors and steroids used to treat severely-ill patients compromise the local and systemic physiologic responses to acute bacterial infection. It is important to reconsider clinical expectations during the pandemic and intervene as early as possible to prevent ongoing damage and clinical deterioration.
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  • 文章类型: Journal Article
    咬伤是由于动物或人类咬伤而发生的。由于与人生活的宠物越来越多,它们相对频繁,以及人类与动物的互动不足。大多数外科医生对这些损伤的管理的知识相对过时,而目前的文献指出了这一领域的重要变化。本文介绍了有关流行病学的几个方面,分类,细菌学,以及手部咬伤的特征。根据实际文献,描述了这些伤害管理的详细规则。该信息可能在经常面临咬伤的急诊科的外科医生和医生的日常实践中被证明是有用的。
    Bite wounds occur as a result of bite by an animal or a human. They are relatively frequent due to the growing number of pets living with people, as well as from inadequate human-animal interactions. The knowledge of most surgeons about the management of these injuries is relatively outdated, whereas the current literature points to important changes in this field. The article presents several aspects concerning epidemiology, classification, bacteriology, and characteristics of bite wounds to the hand. Based on the actual literature, detailed rules for the management of these injuries are described. This information may prove useful in the daily practice of surgeons and doctors at emergency departments who are frequently faced with bite wounds.
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  • 文章类型: Journal Article
    宠物咬伤相关的感染通常是由宠物的口腔菌群通过咬伤传播给动物处理人员引起的。在这项研究中,我们分离出一种链球菌,HKU75T,从先前健康的年轻患者的豚鼠咬伤伤口收集的脓性分泌物中进行纯培养。HKU75T在绵羊血琼脂上呈α-溶血,并与Lancefield组D和G组抗血清凝集。API20STREP显示,HKU75T最可能的身份是S.suisI,置信度为85.4%,而Vitek2显示HKU75T无法识别。MALDI-TOFMS将HKU75T鉴定为猪链球菌(仅得分为1.86)。16SrRNA基因测序显示HKU75T与副猪链球菌关系最密切(核苷酸同一性为98.3%),而部分groEL和rpoB基因测序表明,它与猪链球菌最密切相关(核苷酸同一性分别为81.8%和89.8%)。通过ANI确定的全基因组测序和基因组间距离揭示HKU75T的基因组与所有其他已知链球菌物种的基因组之间存在<85%的同一性。使用92个细菌核心基因的串联序列进行基因组分类显示HKU75T属于Suis组。与HKU75T相同的groEL基因序列可以直接从患者拥有的两只豚鼠的口腔中扩增。HKU75T是一种新型链球菌,我们建议将其命名为S.oriscaviae。豚鼠的口腔大概是S.oriscavia的储库。从临床标本中分离的一些报道的猪链球菌菌株可能是oriscavia。重要性我们报道了一种新型链球菌的发现,提议被命名为oriscavia链球菌,从健康年轻患者的豚鼠咬伤伤口中收集的脓液。该细菌最初被误认为是S.suis/S。通过生化测试,质谱。和管家基因测序。全基因组测序证实了它的新颖性。比较基因组研究表明,oriscaviae属于Suis组。在患者拥有的两只豚鼠的口腔中检测到S.oriscavia序列,这表明豚鼠的口腔可能是S.oriscavia的储库。报道的猪链球菌菌株中的一些可能是S.oriscavia。需要进一步的研究来完善我们对这种新型链球菌的认识。
    Pet bite-related infections are commonly caused by the pet\'s oral flora transmitted to the animal handlers through the bite wounds. In this study, we isolated a streptococcus, HKU75T, in pure culture from the purulent discharge collected from a guinea pig bite wound in a previously healthy young patient. HKU75T was alpha-hemolytic on sheep blood agar and agglutinated with Lancefield group D and group G antisera. API 20 STREP showed that the most likely identity for HKU75T was S. suis I with 85.4% confidence while Vitek 2 showed that HKU75T was unidentifiable. MALDI-TOF MS identified HKU75T as Streptococcus suis (score of 1.86 only). 16S rRNA gene sequencing showed that HKU75T was most closely related to S. parasuis (98.3% nucleotide identity), whereas partial groEL and rpoB gene sequencing showed that it was most closely related to S. suis (81.8% and 89.8% nucleotide identity respectively). Whole genome sequencing and intergenomic distance determined by ANI revealed that there was <85% identity between the genome of HKU75T and those of all other known Streptococcus species. Genome classification using concatenated sequences of 92 bacterial core genes showed that HKU75T belonged to the Suis group. groEL gene sequences identical to that of HKU75T could be directly amplified from the oral cavities of the two guinea pigs owned by the patient. HKU75T is a novel Streptococcus species, which we propose to be named S. oriscaviae. The oral cavity of guinea pigs is presumably a reservoir of S. oriscaviae. Some of the reported S. suis strains isolated from clinical specimens may be S. oriscaviae. IMPORTANCE We reported the discovery of a novel Streptococcus species, propose to be named Streptococcus oriscaviae, from the pus collected from a guinea pig bite wound in a healthy young patient. The bacterium was initially misidentified as S. suis/S. parasuis by biochemical tests, mass spectrometry. and housekeeping genes sequencing. Its novelty was confirmed by whole genome sequencing. Comparative genomic studies showed that S. oriscaviae belongs to the Suis group. S. oriscaviae sequences were detected in the oral cavities of the two guinea pigs owned by the patient, suggesting that the oral cavity of guinea pigs could be a reservoir of S. oriscaviae. Some of the reported S. suis strains may be S. oriscaviae. Further studies are warranted to refine our knowledge on this novel Streptococcus species.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    A 73-year-old male patient suffered multiple dog bites to the left hand and lower arm. The initial treatment in hospital consisted of conservative treatment with wound closure strips and bandages. For further treatment the patient was referred to the general practitioner who found a discharge of pus below the wound closure strips 2 days later. On the 3rd day the patient was admitted to a different hospital where surgical treatment with débridement, placement of vacuum bandages and subsequent flap plasty was conducted on admission. An examination 1 year later revealed stabbing pain over the carpometacarpal joint radiating into the thumb, hypoesthesia of the back of the hand, numbness of the thumb on the ulnar side, reduced range of movement in the wrist and thumb and suspected development of a neuroma. In the subsequent arbitration procedure, the patient criticized the initial treatment and claimed that the bite wounds were not cleansed and were then closed with wound closure strips without antibiotic treatment. This was assumed to have caused extensive infection, which required surgical treatment and caused lasting complaints. The arbitration board report determined an insufficient initial clinical assessment and a faulty wound care resulting in, among other things, reduced range of movement of all fingers of the left hand.
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  • 文章类型: Case Reports
    BACKGROUND: Bite wounds are one of the most common traumatic injuries in dogs and depending on their severity, location, etc., urgent care including antibiotic therapy may be necessary. Serious complications can result from these injuries, such as multiple organ dysfunction syndrome (MODS), as well as a generalized reduction in cerebral perfusion, e.g. during cardiac arrest, shock, or severe hypotension that may cause global brain ischemia (GBI).
    METHODS: A 5-year-old spayed female Maltese dog was presented with generalized seizures, ataxia, and obtunded mentation. The dog was injured by severe bite wounds that penetrated its abdomen and had received blood transfusions, antibiotic therapy (including metronidazole and cefazoline) and underwent emergency surgery 4 days before its visit. Based on a clinical examination, intracranial hypoxic damage with elevated intra-cranial pressure and MODS were highly suspected, and GBI was confirmed following magnetic resonance imaging. Increased signal intensity diffusely distributed in the olfactory bulb and frontal, temporal, and parietal grey matter was evident on the T2-weighted and fluid attenuated inversion recovery transverse images, along with corresponding high signal intensity observed on diffusion weighted imaging. During the 10-month follow-up period, the clinical signs gradually improved, but intermittent circling and cognitive dysfunction deficits remained.
    CONCLUSIONS: GBI should be included among the differential diagnoses in case of any peracute non-progressive neurological dysfunction that occurs with episodes of hypotension or hypoxia. The abnormal signal intensity observed on diffusion weighted imaging was a useful indicator for diagnosing this condition. Long-term medical management with antibiotics and anti-convulsant and anti-oxidant therapies were considered to be helpful in managing the GBI concurrent with MODS in this dog.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    OBJECTIVE: To report a case series of thoracic bite trauma in dogs and cats and to evaluate risk factors for mortality.
    METHODS: A retrospective study concerning thoracic bite wounds in dogs and cats was performed. Lesions were categorized by depth of penetration: no wound, superficial, deep or penetrating. Thoracic radiographic reports were reviewed. Lesion management was classified as non-surgical, wound exploration, or explorative thoracotomy.
    RESULTS: Sixty-five cases were collected. Twenty-two percent of patients with normal respiratory patterns showed thoracic radiographic lesions. Respiratory distress was not correlated with mortality. Twenty-eight patients were presented with superficial wounds and 13 with deep wounds. Eight patients exhibited penetrating wounds. Radiographic lesions were observed in 77% of dogs and 100% of cats. Explorative thoracotomy was performed in 28% of patients, and surgical wound exploration in 17.2%. With the exception of skin wounds, thoracic wall discontinuity was the most frequent lesion. Thoracotomy was associated with increased length of hospitalisation but was not correlated with mortality. The mortality rate was 15.4%. No studied factor correlated with mortality, and the long-term outcomes were excellent.
    CONCLUSIONS: A penetrating injury, more than three radiographic lesions, or both together seemed to be indicative of the need for a thoracotomy. In the absence of these criteria, systematic bite wound explorative surgery is recommended, with extension to thoracotomy if thoracic body wall disruption is observed.
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