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Human bites are typically complicated by

Eikenella corrodens

Bacteroides sp.

Typically, patients may be discharged with a broad-spectrum oral

antibiotic with anaerobic coverage. Good choices include amoxicillin-

clavulanate, clindamycin, and ciprofloxacin.

Mupirocin® ointment can be applied topically to the wound and

utilized for approximately 1 week post-repair.

c. Testing for Communicable Diseases

Human bites may transfer hepatitis B and C, herpes virus, and human

immunodeficiency virus (HIV). It is good practice to treat a human bite

as a possible HIV exposure. An HIV test should be performed on both

patient and attacker, if possible. Eliciting a history of other communi-

cable diseases in both patient and attacker is also prudent.

d. Scar Revision

Recipients of human bites should be made aware of probable less than

ideal wound healing, and probable need for scar revision.

e. Intravenous Bolus of a Second-Generation Cephalosporin

An intravenous bolus of a second-generation cephalosporin (cefurox-

ime, cefoxitin) should be administered for all penetrating soft tissue bite

wounds. If penicillin sensitivity cross-reaction is a major concern with a

cephalosporin, then parenteral ciprofloxacin is a good choice.

Alternatively, clindamycin may be considered.

f. Parenteral Antibiotic Therapy

If wounds are severe, consider continued parenteral antibiotic therapy,

either as inpatient treatment or home intravenous therapy.

g. Adhesive Dressings

Bite wounds should not be concealed by adhesive dressings, as it is

important to observe the wound for infection and allow slight laxity of

the wound margins for seepage of serous fluid.

E. Burn Injuries

Burn injuries may result from thermal injury, ingestion of caustic agents,

and electrical shock. When they occur, they are more commonly seen in

the pediatric population. Burn injuries tend to propagate beyond the

focus of the insult, and damage may escalate for some time after the

traumatic event. Management is complex and ongoing over time.

However, some tenets must be followed early on in the emergency

setting.