Soft tissue infections due to human bites
- Larry M Baddour, MD, FIDSA, FAHA
Larry M Baddour, MD, FIDSA, FAHA
- Professor of Medicine
- Mayo Clinic College of Medicine
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 "Clinical manifestations and initial management of animal and human bites".)
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 . 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 .
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".)
Purposeful injury to one individual by another may result in occlusional bites or clenched-fist injuries . 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.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis 2014; 59:147.
- Brook I. Bacteriologic study of paronychia in children. Am J Surg 1981; 141:703.
- Talan DA, Abrahamian FM, Moran GJ, et al. Clinical presentation and bacteriologic analysis of infected human bites in patients presenting to emergency departments. Clin Infect Dis 2003; 37:1481.
- Figueiredo JF, Borges AS, Martínez R, et al. Transmission of hepatitis C virus but not human immunodeficiency virus type 1 by a human bite. Clin Infect Dis 1994; 19:546.
- Bartholomew CF, Jones AM. Human bites: a rare risk factor for HIV transmission. AIDS 2006; 20:631.
- Shapiro CN. Transmission of hepatitis viruses. Ann Intern Med 1994; 120:82.
- Vidmar L, Poljak M, Tomazic J, et al. Transmission of HIV-1 by human bite. Lancet 1996; 347:1762.
- Dusheiko GM, Smith M, Scheuer PJ. Hepatitis C virus transmitted by human bite. Lancet 1990; 336:503.
- Davis LG, Weber DJ, Lemon SM. Horizontal transmission of hepatitis B virus. Lancet 1989; 1:889.
- Oh Y, Ahn SY, Hong SP, et al. A case of extragenital chancre on a nipple from a human bite during sexual intercourse. Int J Dermatol 2008; 47:978.
- Fallouji MA. Traumatic love bites. Br J Surg 1990; 77:100.
- Wolf JS Jr, Gomez R, McAninch JW. Human bites to the penis. J Urol 1992; 147:1265.
- Henry FP, Purcell EM, Eadie PA. The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon. Emerg Med J 2007; 24:455.
- Goldstein EJ. Bite wounds and infection. Clin Infect Dis 1992; 14:633.
- Zubowicz VN, Gravier M. Management of early human bites of the hand: a prospective randomized study. Plast Reconstr Surg 1991; 88:111.
- Medeiros I, Saconato H. Antibiotic prophylaxis for mammalian bites. Cochrane Database Syst Rev 2001; :CD001738.