What are the complications of a human bite?
Infection is the most common complication and it occurs in 9-50 out of every 100 human bites. The usual type of infection is with a type of germ called bacteria. This can be infection of the surrounding skin (cellulitis). It may also spread to tissues close to the skin - in particular, bones (osteomyelitis) or tendons (infectious tenosynovitis). Occasionally infection can spread further, causing infection around the brain (meningitis), of the heart (endocarditis) or throughout the body (sepsis or streptococcal toxic shock syndrome).
Other infections which may be transmitted through human bites include:
Hepatitis C and HIV are very unlikely to be spread from a bite. In order to get one of these infections from a bite, there usually has to be blood in the saliva of an infected person biting. Hepatitis B is more likely to spread via saliva but it is still much rarer than through needlestick injuries.
Other complications include disfigurement or deformity of the affected part. This may occur if there is a large scar, or if bones and tendons have become involved. Certain parts of the body do not heal very well if cut, such as the ear or nose, and may become deformed as they heal from a bite.
Who is particularly at risk of complications after a human bite?
Some people are more at risk of infection following a bite. For example:
- Those who have an immune system which does not work very well. This may be due to not having a spleen, from certain medication, from chemotherapy or from illness such as AIDS.
- Older people.
- People with diabetes.
Some specific wounds are more at risk of infection. For example:
- Bites to the hands or feet.
- Bites which have had stitches to close the wound.
- Deep bites.
- Bites on the head or face of a baby or infant.
- Bites over joints.
Can these complications be prevented?
Infection with germs (bacteria) can be prevented by using an antibiotic. Usually the one used is an antibiotic called co-amoxiclav. Many doctors treat all human bites with antibiotics to be on the safe side. Others only treat those which are at high risk of infection. Early antibiotics help to reduce the chance of any deformity or loss of function.
People who are at higher risk of infections such as hepatitis B or HIV include men who have sex with men, intravenous drug users, and sex workers. If you have been bitten by someone in one of these categories, you might be considered to be at high risk. If you are considered to be at high risk of developing hepatitis B, you may be given a vaccination to try to prevent this. If you are at high risk of catching HIV from the bite, you may be given some medication to try to prevent this.
What should I look out for after a human bite?
The most common complication following a bite is infection of the wound. See a doctor if the skin surrounding a wound becomes more tender, painful, swollen, or reddened over the few days following the bite.
Rarely, some germs (bacteria) can get into the bloodstream through a wound and cause a serious infection in the body. See a doctor if you become generally unwell with a high temperature (fever), shivers, or other worrying symptoms within a week or so after a bite.
Further reading and references
Bites - human and animal; NICE CKS, July 2015 (UK access only)
Harrison M; A 4-year review of human bite injuries presenting to emergency medicine and Injury. 2009 Aug40(8):826-30. Epub 2009 Feb 1.
Guidelines for the emergency management of injuries (including needlesticks and sharps injuries, sexual exposure and human bites) where there is a risk of transmission of bloodborne viruses and other infectious diseases; EMI toolkit, Health Protection Surveillance Centre, September 2012
Patil PD, Panchabhai TS, Galwankar SC; Managing human bites. J Emerg Trauma Shock. 2009 Sep2(3):186-90. doi: 10.4103/0974-2700.55331.
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