Lee, Ryun
(Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital)
,
Lee, Hee Young
(Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital)
,
Kim, Ji Hyun
(Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital)
,
Han, Yea Sik
(Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital)
,
Kim, Dong Chul
(Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital)
,
Tark, Kwan Chul
(Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital)
As many people keep small dogs as pets, dog bites are common injuries, accounting for approximately 80%-90% of all animal bite injuries. These injuries usually occur on the upper extremities, most commonly on the fingers. Most of these injuries appear as simple lacerations or abrasions of the skin. ...
As many people keep small dogs as pets, dog bites are common injuries, accounting for approximately 80%-90% of all animal bite injuries. These injuries usually occur on the upper extremities, most commonly on the fingers. Most of these injuries appear as simple lacerations or abrasions of the skin. Common symptoms include inflammatory reactions of the soft tissue, such as pain, swelling, erythema, and cellulitis. However, the complications of small dog bites may include joint or cartilage injuries, including acute osteomyelitis. Once osteomyelitis develops, it is difficult to diagnose since it has a latency period of approximately 2 weeks. Plain radiography, magnetic resonance imaging, and 3-phase bone scans should be performed when acute osteomyelitis is suspected, and broad-spectrum empiric antibiotic treatment should be administered for approximately 8-12 weeks. We report 3 very rare cases of acute osteomyelitis that occurred after a dog bite injury.
As many people keep small dogs as pets, dog bites are common injuries, accounting for approximately 80%-90% of all animal bite injuries. These injuries usually occur on the upper extremities, most commonly on the fingers. Most of these injuries appear as simple lacerations or abrasions of the skin. Common symptoms include inflammatory reactions of the soft tissue, such as pain, swelling, erythema, and cellulitis. However, the complications of small dog bites may include joint or cartilage injuries, including acute osteomyelitis. Once osteomyelitis develops, it is difficult to diagnose since it has a latency period of approximately 2 weeks. Plain radiography, magnetic resonance imaging, and 3-phase bone scans should be performed when acute osteomyelitis is suspected, and broad-spectrum empiric antibiotic treatment should be administered for approximately 8-12 weeks. We report 3 very rare cases of acute osteomyelitis that occurred after a dog bite injury.
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제안 방법
She was admitted, and incision and drainage were performed under local anesthesia. A 3-phase bone scan examination was performed, and the exam revealed a marked accumulation of radioactivity at the shaft of the first metacarpal bone. With the impression of acute osteomyelitis, intravenous antibiotic treatment with moxifloxacin and clindamycin was administered for 5 weeks.
A simple wound dressing was performed and the patient was discharged with a prescription for an ordinary third-generation oral cephalospo-rin. Four days later, the patient revisited our clinic center with noticeable swelling, erythema, and tenderness on her left thumb and stiffness of the interphalangeal thumb joint. She was initially diagnosed with cellulitis on her thumb and admitted after a Gram-stain wound culture was conducted.
The physical examination showed erythema around the wound with mild tenderness and pus-like discharge. She was admitted, and incision and drainage were performed under local anesthesia. A 3-phase bone scan examination was performed, and the exam revealed a marked accumulation of radioactivity at the shaft of the first metacarpal bone.
Ten days after the injury, debridement and open reduction were performed under general anesthesia. Three weeks after injury, a 3-phase bone scan and a MRI examination were performed to evaluate whether osteomyelitis was present. The 3-phase bone scan showed a marked accumulation of radioactivity in the distal phalanx of the right thumb (Fig.
대상 데이터
A 34-year-old male patient visited our emergency center after he was bitten on his right thumb by his pet dog (a Maltese). His distal phalanx was diagnosed with an open fracture, and after open reduction and primary closure of the wound, he was discharged for follow-up.
A 43-year-old female patient visited our clinic with a laceration wound (approximately 1 cm) on her right thenar area due to a bite injury by pet dog (an American Eskimo). The physical examination showed erythema around the wound with mild tenderness and pus-like discharge.
A 59-year-old female patient visited the emergency center of our hospital with a small (0.5 cm long) laceration wound on the distal phalanx (volar and ulnar sides) of her left thumb due to a bite injury by her small pet dog (a Spitz). The patient and dog had both been previously vaccinated against tetanus and rabies respectively.
성능/효과
Intravenous antibiotic treatment with moxifloxacin and clindamycin was administered for 5 weeks, and 7 additional weeks of treatment with the oral forms of the same drugs were prescribed. After 12 months, a follow-up 3-phase bone scan showed complete resolution of the osteomyelitis, and the finger-tip contour was excellent, without joint stiffness or limitation of joint movement (Fig. 8).
The patient also underwent additional 7 weeks of treatment with the oral forms of the same drugs. After the antibiotic treatment was completed, a follow-up 3-phase bone scan was performed, complete resolution of the osteomyelitis was confirmed, and there were no complications such as tenderness or swelling.
She then underwent 7 additional weeks of treatment with the oral forms of the same drugs. At the end of 12 weeks of treatment, a followup 3-phase bone scan was performed, and it showed complete resolution of the osteomyelitis (Fig. 4). At a 2-month follow-up after finishing the course of medication, no complications, suchas tenderness, erythema, or swelling, were found.
참고문헌 (11)
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