Animal bite

Introduction

Animal bites are common: it is estimated that several thousand bites are recorded each year in Switzerland, most often by dogs, more rarely by cats, other mammals, or by humans. Even when superficial, these bites can lead to serious complications: infections, disease transmission (tetanus, rabies), tendon or nerve damage, and psychological impact. Early and appropriate management is essential to prevent complications and preserve function.

In case of a bite, wash the wound immediately with plenty of soap and water, then contact your treating physician. If they are unavailable, Docadom offers an emergency consultation with an on-call doctor at home: call 021 845 45 45 or use our app available on the App Store and Google Play.

Who is at risk?

Anyone in contact with animals is exposed. Children are particularly at risk, due to their size and their sometimes inappropriate behavior around animals (faces at mouth level). Animal owners, professionals (veterinarians, breeders, farmers, postal workers, guards), travelers in rabies-endemic areas, and victims of violence (human bites) are other exposed populations. Patients who are immunocompromised, diabetic, asplenic, or on anticoagulants are at increased risk of complications.

Symptoms and Immediate Complications

The consequences of a bite depend on the animal, depth, location, and the delay in seeking medical care.

Initial Clinical Picture

• Wound: punctures, lacerations, tears, sometimes with tissue damage.

• Bleeding, more or less heavy.

• Pain.

• Possible associated injuries: tendons, nerves, vessels, bones (fractures).

• Swelling and redness around the wound in the following hours.

Signs of Infection (at 24-72 hours)

• Spreading redness, increased swelling.

• Increasing pain.

• Local warmth.

• Purulent discharge.

• Fever, chills.

• Swollen lymph nodes in the drainage area.

• Signs of severity: lymphangitis (red streak), extensive cellulitis, sepsis.

When to seek urgent medical attention?

An emergency consultation is necessary in the following situations:

• Deep, extensive wound, or with heavy bleeding.

• Bite to the face, hands, feet, or near a joint.

• Bite from a wild animal or unknown animal.

• Suspected rabies (animal with abnormal behavior, in an endemic area, or unvaccinated).

• Bite in a child, elderly person, or a patient who is immunocompromised, diabetic, or on anticoagulants.

• Signs of infection appearing in the hours or days following.

• Uncertain or outdated tetanus vaccination status.

• Human bite, particularly on the hand (very high risk of infection).

• Signs of severity: fever, mottling, low blood pressure, confusion — call 144.

What to do before calling Docadom? Wash the wound immediately with soap and water for at least 5 minutes, disinfect with an antiseptic (chlorhexidine, povidone-iodine), and cover with a clean bandage. Contact your treating physician first. If they cannot be reached, call Docadom at 021 845 45 45 or make your request directly from our smartphone app (App Store and Google Play). In case of heavy bleeding, facial wound with extensive damage, signs of sepsis, or suspected rabies, dial 144 without delay.

Infectious Risks

Bacterial Infections

The primary risk. The bacteria involved vary depending on the animal:

• Dog and cat: Pasteurella multocida (highly virulent, infection within 24 hours), Capnocytophaga canimorsus (severe form in asplenic or immunocompromised patients), Staphylococcus aureus, Streptococcus, anaerobes.

• Human bite: Eikenella corrodens, streptococci, anaerobes, viruses (HIV, hepatitis B and C in very rare cases).

• Rat: risk of leptospirosis, sodoku (rat-bite fever).

Rabies

Rabies is a viral disease that is almost always fatal once symptoms appear. It is transmitted by the saliva of an infected animal (dog, cat, bat, fox, wild mammal). Any bite from an unknown or suspicious animal, especially in endemic areas (Africa, Asia, Latin America), requires an urgent medical evaluation to discuss post-exposure prophylaxis (rabies vaccination +/- immunoglobulins).

Tetanus

Tetanus is a serious infection caused by Clostridium tetani, which is found in soil. Any soiled wound warrants checking your tetanus vaccination status: a booster shot or immunoglobulins may be necessary.

Medical Management

Local Wound Care

• Abundant washing with soap and water, followed by disinfection.

• Exploration of the wound to look for tendon, nerve, vascular, or bone damage.

• Surgical debridement for extensive, deep, or soiled wounds.

• Immediate suturing is often to be avoided (risk of infection). Exception: face wounds for aesthetic reasons.

• Bandaging and monitoring.

Antibiotic Prophylaxis and Antibiotic Therapy

Antibiotic prophylaxis is recommended for high-risk bites (deep wounds, hands, face, joints, patients at risk). The reference antibiotic is amoxicillin-clavulanic acid for 5 to 7 days. If there are signs of infection, the antibiotic therapy is curative and tailored to the antibiogram.

Tetanus and Rabies Vaccination

• Tetanus vaccine: booster required if the last injection was > 5 years ago (10 years depending on recommendations); tetanus immunoglobulins if vaccination status is uncertain.

• Post-exposure rabies prophylaxis: 4-dose rabies vaccination, sometimes combined with immunoglobulins, to be started urgently in case of high-risk exposure.

Bite Prevention

• Teach children to respect animals: do not disturb a dog that is eating or sleeping, do not pull its tail, and do not approach an unknown animal.

• Never leave a young child alone with an animal.

• Education and socialization of pets.

• Up-to-date vaccinations for pets (rabies, tetanus for horses).

• Avoid stray or wild animals, especially bats.

• When traveling in a rabies-endemic area: preventive rabies vaccination.

• Wearing protective equipment for exposed professionals.

• Regular updates of tetanus vaccine (booster every 10 years).

Possible Complications

The most common complications are local infections and their spread (cellulitis, abscess), joint infections (particularly septic arthritis of the hands), systemic infections (septicemia, septic shock due to Capnocytophaga in asplenic patients), tetanus, and rabies. Bites can also result in functional sequelae (tendon, nerve), unsightly scars, especially on the face, and psychological impact (anxiety, post-traumatic stress disorder, especially in children).

When to Contact a Doctor for an Animal Bite

Any bite warrants medical advice, except for very superficial bites in a patient whose vaccinations are up-to-date:

• As a first step: contact your treating physician, who can assess the wound, update vaccinations, and prescribe potential antibiotic prophylaxis.

• If your treating physician is unavailable (evenings, weekends, holidays), Docadom offers an emergency consultation with a doctor at home. Call 021 845 45 45 or make your request via our mobile app, available for free on the App Store and Google Play.

• In case of severity signs (devastating wound, uncontrolled bleeding, suspected rabies, signs of sepsis), dial 144 immediately or go to the emergency room.

Conclusion: wash, disinfect, consult

Animal bites are wounds that should never be ignored. They are characterized by a wound that is more or less deep, sometimes associated with bleeding and damage to deep structures, which can lead to complications such as local or systemic infection, tetanus, or rabies. The essential steps are abundant washing, disinfection, checking tetanus vaccination status, potential antibiotic prophylaxis, and systematic medical evaluation.

After a bite, contact your treating physician first. If they are not available, Docadom provides you with an emergency home doctor 7 days a week: call 021 845 45 45 or use our mobile app (App Store, Google Play) to request an emergency consultation.