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Review Question - QID 107638

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QID 107638 (Type "107638" in App Search)
A child is brought into the emergency room by her mother. Her mother states that the 7-year-old child was playing with their dog, who is up to date on his vaccinations. When the dog started playing more aggressively, the child suffered a bite on the hand with two puncture wounds from the dog's canines. The child is up-to-date on her vaccinations and has no medical history. Her vitals are within normal limits. If this bite becomes infected, what is the most likely organism to be the cause of infection?

Clostridium perfringens

6%

1/17

Pseudomonas aeruginosa

0%

0/17

Pasteurella multocida

71%

12/17

Clostridium tetani

0%

0/17

Fusobacterium

18%

3/17

Select Answer to see Preferred Response

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A child bit by a dog or a cat is most likely to be infected by the causative agent Pasteurella multocida.

Dog and cat bites annually cost $50 million to the US healthcare system, and the most common victims are children who are familiar with the dog or cat. These bites should be handled with care and should be thoroughly cleaned and irrigated (if possible, with sterile saline) with a visit to a physician for further assessment. The most common organism responsible for infection in dog and cat bites is Pasteurella multocida (P. multocida), while the most common organisms responsible for human bite infections are staph, strep, and fusobacterium species.

Ellis et al. discuss the guidelines for dog and cat bites. They state that certain factors increase the risk of infection including bites involving the hand, near a prosthetic joint, crush injuries, puncture wounds, and bites in patients with immunocompromising conditions. In these high-risk cases, they recommend cleaning the wound with a diluted iodine solution, treating with amoxicillin/clauvulonic acid, and recommend using secondary intention for wound closure instead of primary closure.

Doxin et al., in their retrospective study, discuss prevention and education regarding dog bites in the pediatric population. They discovered that, of their cohort, only 6% of the children received education on bite prevention even though 77% of the cohort has pet dogs. They noted that, after providing information, the rate of passing the bite prevention test increased from 58% to 90%. They also noted that that younger age was significantly associated with failing the bite prevention test (p<0.001).

Incorrect Answers:
Answers 1: Clostridium perfringens can be a common cause of infection in wounds that takes place in the setting of trauma with exposure to soil and sand.
Answer 2: Pseudomonas infections are common in patients who are immunocompromised (such as diabetics or patients on immunomodulating therapies) and are also causes of infections in patients on ventilators.
Answer 4: Clostridium tetani infections are typically caused by wound due to injury with metal or iron objects but have become a less common problem due to vaccination.
Answer 5: Fusobacterium, along with streptococcus and staphylococcus, are common causes of infections from human bites.

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