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Soft tissue infections due to human bites

Author
Larry M Baddour, MD, FIDSA
Section Editor
Daniel J Sexton, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Human bite wounds can occur as a result of incidental or purposeful injury and are more prone to infection than animal bites. This topic will review the microbiology, clinical evaluation, and management of soft tissue infections due to human bites. Soft tissue infections due to dog and cat bites and animal and human bites in children are discussed separately. (See "Soft tissue infections due to dog and cat bites" and "Initial management of animal and human bites".)

MICROBIOLOGY

Human bite wound pathogens consist of both aerobic and anaerobic bacteria, including streptococci, Staphylococcus aureus, Eikenella, Fusobacterium, Peptostreptococcus, Prevotella, and Porphyromonas spp [1-3]. In a study of 50 patients with infected human bites, the median number of isolates per wound culture was four [3]. Both aerobes and anaerobes were isolated from 54 percent of wounds, aerobes alone were isolated from 44 percent, and anaerobes alone were isolated from 2 percent.

Viral pathogens, including hepatitis, human immunodeficiency virus, and herpes simplex virus, are transmissible by human bites; clinical descriptions are limited to case reports [4-9]. Human bite transmission of syphilis has also been described [10].

CLINICAL EVALUATION

Human bite wounds can occur as a result of incidental or purposeful injury. Incidental injury may include self-inflicted wounds (such as paronychia due to nail biting or thumb sucking) or "love nips" to the face, breasts, or genital areas [11,12]. (See "Paronychia and ingrown toenails".)

Purposeful injury to one individual by another may result in occlusional bites or clenched fist injuries [13]. Occlusional bites are frank bites by human teeth, most often to the fingers, hands, or arms. Involvement of the hand portends high risk for osteomyelitis and septic arthritis.

         

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Literature review current through: Nov 2016. | This topic last updated: Mon Mar 07 00:00:00 GMT 2016.
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