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22 - Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia

from Part I - Systems

Published online by Cambridge University Press:  15 December 2009

By
Michael Kohn
Edited by
Rachel L. Chin
Michael Kohn
Affiliation:
Associate Clinical Professor of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA; Attending Emergency Physician, Mills-Peninsula Medical Center, Burlingame, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

FIGHT BITE

Introduction – Agents

The most notorious of all nonvenomous bite wounds is the fight bite. As the name implies, this injury occurs when the subject punches an adversary in the teeth, lacerating the dorsum of one or more metacarpal-phalangeal (MCP) joints (Figure 22.1). Other names for this injury, such as “morsus humanus” or “clenched fist injury,” have been proposed, though “fight bite” is more descriptive and widely used. The fight bite gave human bites their reputation for being more prone to infection than other animal bites. This has more to do with the location of the bite and the typical delay in treatment than with the mix of organisms in the human mouth. Common fight bite infections include cellulitis, subcutaneous abscesses, septic MCP joint, and purulent tenosynovitis. In the preantibiotic era, fight bite infections commonly necessitated finger and occasionally arm amputations. Fight bite infections are usually polymicrobial and often involve Streptococcus species, Staphylococcus species, Eikenella, and oral anaerobic bacteria.

The first two fight-bite patients reported in the medical literature were described by William H. Peters in 1911. He was primarily concerned with culturing mouth organisms, specifically Fusobacteria, from the infected wounds. Various other studies emphasizing the symbiosis of spirochetes and fusiform organisms in fight bites appeared afterwards.

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Emergency Management of Infectious Diseases , pp. 121 - 126
Publisher: Cambridge University Press
Print publication year: 2008

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References

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  • Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia
    • By Michael Kohn, Associate Clinical Professor of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA; Attending Emergency Physician, Mills-Peninsula Medical Center, Burlingame, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.023
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  • Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia
    • By Michael Kohn, Associate Clinical Professor of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA; Attending Emergency Physician, Mills-Peninsula Medical Center, Burlingame, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.023
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia
    • By Michael Kohn, Associate Clinical Professor of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA; Attending Emergency Physician, Mills-Peninsula Medical Center, Burlingame, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.023
Available formats
×