What is Human Bites?
Human bites make up only a small portion (3%) of all bite injuries treated in the emergency department, but they can lead to serious health problems. This is usually because these injuries are hard to identify and patients often come in late once an infection has already set in. Most of the medical costs for these injuries come from treating the infection and post-infection care, so it’s very important to diagnose the injury early and stop it from getting worse.
What Causes Human Bites?
Human bites are usually different from other animal bites. They often happen when one person punches another in the face, causing their hand to get cut on the other person’s teeth. This is called a closed-fist injury. There are also bites that occur when something gets caught between the teeth, these are called occlusion bites.
Occlusion bites carry the same risks as closed-fist injuries, but they are generally easier to identify. They are less likely to result in skin breakages over parts of the body where there’s something directly underneath the skin.
Risk Factors and Frequency for Human Bites
Human bites account for roughly 3% of all bite injuries that emergency departments handle. These are often a result of someone making a fist and hitting another person, but the type of injury depends on the age of the person involved.
- For kids, bites usually occur on their face and upper body from rough play and are typically the result of someone’s mouth closing on their skin.
- For people in other age groups, the bite is frequently located at the joint where the hand and finger meet, normally on the third, fourth, or fifth finger. This usually happens when someone hits another person in the face or comes into contact with someone else’s teeth.
Most of the recorded bites are of the closing mouth variety, but this might not paint the full picture. This is because people who’ve hurt their hand in a fight (what we call ‘fight bites’) might not admit to how they got injured. They might come in with complaints about other injuries and the bite is only noticed upon examination. Fight bites are most common in males aged from their teens to young adulthood.
Signs and Symptoms of Human Bites
When conducting a thorough physical examination for a bite wound, the doctor needs to understand the details surrounding the bite event. They need to find out where the bite is located, whether it was contaminated with blood, the health condition of both individuals involved, and the time since the bite happened. Other factors to consider include whether the patient has had a fever, or if redness, swelling, warmth, or pus is present at the bite site.
Extra care is necessary when dealing with bite marks in children. If the tooth marks (specifically, the distance between the canine teeth) are wider than 3 cm, it probably came from an adult, which could indicate abuse. Situations such as fights also require attention; anyone coming in with injuries following a dispute should have their hands checked for possible “fight bites”. Conversely, if someone comes in with lacerations (cuts) on their hands, particularly over their knuckle joint, they should be questioned about how they got the wounds.
Another essential detail to note is the affected person’s vaccination status, especially when there’s a risk of disease transmission from the bite.
Testing for Human Bites
Most recent wounds are generally not too serious. They’re often small, less than an inch long, and don’t go very deep. Because of this, these wounds might not get the attention they need, especially if there are other injuries or medical problems to deal with.
If the skin on your hands is dirty or otherwise not clearly visible, then it’s important to clean it thoroughly. You might have a “fight bite,” which is a specific type of wound related to punching someone or something. This is particularly common in individuals who have consumed a lot of alcohol and may not be able to recall how they got injured. In these cases, antibiotics may be needed to prevent infection in the joints or tendon sheaths (the slippery coverings that allows tendons to move smoothly).
For children, bite marks can sometimes signal abuse. If abuse is suspected, a detailed examination should be done, the child’s history should be collected in greater detail, and the Child Protective Services should be contacted for further assistance.
Treatment Options for Human Bites
All skin breaks caused by human bites should be very thoroughly cleaned. If the patient isn’t up to date with their tetanus shots (a vaccine that helps prevent a bacterial infection), they should be given one. Pain relief should be offered before the wound is examined, cleaned, or treated further.
Everyone with a bite that has broken their skin should take a week’s course of amoxicillin-clavulanate. This is a type of antibiotic that helps prevent infection. At the same time, it’s important that the patient takes good care of the wound to help it heal. This includes keeping it clean and changing dressings regularly.
If they have a wound on their MCP-joint – the part where the fingers bend towards the palm – doctors will assume that this is a “closed-fist injury” until they can confirm that’s not the case. A closed-fist injury happens when someone’s teeth pierce the skin on a knuckle. If there are any signs of infection in a joint or a tendon sheath (the protective covering on a tendon), a specialist (called an orthopedist) should be called to check on that. This may need to be cleaned out through a surgical process and requires hospital treatment with antibiotics given directly into a vein.
The wound from a human bite should be treated the same way as any other bite. In most cases, the wound should be allowed to heal naturally. This can help to prevent creating a warm, damp place where bacteria can multiply, which could lead to infection.
What else can Human Bites be?
Some conditions that may be relevant to consider include:
- Animal bites to the head and neck
- Cellulitis (a skin infection)
- Hand infections
- Inflammatory breast cancer
- Insect bites
- Paget’s disease (a type of bone disease)
- Tetanus (an infection affecting the nervous system)
- Thrombophlebitis (vein inflammation due to blood clots)
- Radiation fibrosis (a side effect from radiation therapy)
Possible Complications When Diagnosed with Human Bites
- Change in physical appearance
- Loss of normal function
- Infection of the tendon sheath
- A severe skin infection that kills the body’s soft tissue, often called “flesh-eating disease”
- Pus-filled pain and swelling
- Removal of a limb or part of a limb
- Infection in the bone
- Infection in a joint
