Infektionen nach Bissverletzungen

Abstract

Rat bite fever due to Streptobacillus moniliformis induces typical but not pathognomonic clinical signs, such as local purulent wound infection followed by maculopapular exanthema, myalgia as well as purulent joint infections. Severe complications, such as osteomyelitis and endocarditis are possible. it seems that this infection is rarely diagnosed but this infection could be much more common because the final diagnostic proof is difficult to achieve. Firstly, the culture of these bacteria is critical because the bacteria are fastidious and secondly the exact differentiation of the isolates is hardly possible by standard laboratory methods. Modern techniques such as mass spectroscopy (MALDI-TOF) and molecular biology allow a precise clarification. Surgical cleansing of infection sites in combination with a rational antibiotic therapy, for example with beta-lactam antibiotics, are generally able to cure the infection if treatment is started early enough. In addition, vaccinations, for example against tetanus and rabies have to be considered in this situation as for all other bite wound infections.

Canibacter oris – a fairly unknown pathogenic agent of bite wound infections

“…and Clostridium spp. that often produce betalactamases are rather frequently found among the complex bacterial flora in bite wounds [ 4 ], it is advisable to protect ampicillin by betalactamase inhibitors such as sulbactam. Since most antibiotics do not penetrate well into necrotic and purulent tissues, such antibiotic regimens are only indicated in addition to surgical sanitation.…”

“…The risk of manifest infection after a bite injury is about 10% due to pathogens residing in the oral microbiome of animals and humans, respectively [ 1 ], [ 2 ]. A typical agent of dog and cat bite wounds is Pasteurella multocida [ 3 ], whereas Streptobacillus moniliformis is typically found in rat bite wounds [ 4 ]. In addition to these key bacteria, several others, such as Staphylococcus aureus , Streptococcus pyogenes , Bacteroides spp., Fusobacterium spp., Eikenella corrodens , Capnocytophaga spp.…”

“…and Aggregibacter spp. are found relatively often [ 4 ]. But obviously much more fastidious bacteria like Actinobacteria are present in animal-caused bite wounds when special culture conditions and molecular methods for differentiation are used [ 5 ].…”