Human bite infections

Abstract

1. 1. Sixty-eight cases of infections caused by human teeth are reported. Thirty-eight involved the metacarpophalangeal joint regions, having resulted from fist fight injuries. Thirty were caused by actual bites. 2. 2. Superficial abrasions and avulsive bites did not cause serious infections. Penetrating bites and fist fight injuries to knuckles resulted in the most serious complications, of which the most common were abscess, tissue necrosis, sloughing of tendons, osteomyelitis, and suppurative arthritis. The discharge in these cases was very offensive and malodorous. Late sequelae were stiff fingers from tendon destruction, soft tissue scarring and ankylosis of joints. 3. 3. Nine amputations were done. Two of these were of stiff, useless fingers after the infection had subsided. Seven were of fingers because of extensive severe active infection, and of these two later required forearm amputations to control spreading infections. 4. 4. Smears of discharge in forty-one cases revealed both the fusiform bacillus and the spirochete of Vincent in ten, while eleven others showed the fusiform bacillus but not the spirochete. A majority of the cultures from these cases yielded Staphylococcus aureus and a few yielded Streptococcus viridans and Streptococcus hemolyticus. 5. 5. Oxidizing agents, such as hydrogen peroxide and sodium perborate, applied to the wounds appeared to produce more rapid healing than when ordinary hot wet soaks were used. Intravenous neoarsphenamine had no appreciable influence on the repair of these wounds.