So on Friday arvo, after school, the grandkid was visiting a mate and was bitten by a dog. I’m not sure of the exact details, I believe kiddo was patting a friendly dog behind a fence, when this other bloody mongrel came belting up and bit the kid on the arm. Badly. Two deep puncture wounds.
My daughter took kid to the doctor immediately, they cleaned the wound and dressed it, but didn’t recommend a tetanus shot nor prophylactic antibiotics. Just told to take him home, and see how he goes over the weekend.
Well, the weekend was fine, but this morning the kid woke up with a bright red arm oozing the most foul-smelling exudate. I can’t begin to describe the ‘fragrance’, it was goddamned awful.
Off to A & E, there was a BIG wait until they got to see a doc unfortunately, but he is now admitted, on IV antibiotics and just waiting for surgery tomorrow to clean out the wound. And apparently he’s as happy as larry, soaking up the attention, the food, and the fact he got a day off school.
To add: I am VERY pissed off with the original doc who didn’t think the wound warranted a tetanus jab and/or antibiotics. It was a deep bite, and only 2.5 days later, it’s a horrible mess of horrible stuff. Bloody bugger will get a stern hearing from me when I see him next.
Wow ! What an awful story. I’m sorry that your grandchild (and you) had to deal with that. But awfully glad he’s (belatedly) getting the care he needs, and is in good spirits about the whole thing.
Yeah, tetanus is definitely SOP here, but thankfully, no rabies in Australia. But with all the other shit dogs eat, it isn’t really remarkable that the kid has an infected arm.
Dogs up here have a habit of going gah-gah on cane-toads. It’s sort of like LSD for canines, and it will either make them terribly sick (like our pupper when we first brought her home) or get them groovin’ on the vibes, and the dog will actively seek them out to get their fix.
So, chances are, not only had this cur been eating shit, but licking cane-toads, which will make the infection doubly hard to contain.
OK, bit of an update. Apparently an AMBULANCE was called after the dog bite, and the paramedics cleaned the bite and told my daughter/kidlet it would be ok and just to wait out the weekend before getting medical attention. So I shall not yell at our Doctor.
If the child had completed their primary tetanus series and was within five years of the last dose then prophylaxis would not be indicated. It also would not have impacted this infection happening.
The big deal for a dog bite is cleaning the wound well. Most of the time prophylactic antibiotics are indicated for cat bites but not as frequently for dog bites. They tend to be broader than deep unlike cat bites that are deep puncture wounds. Less risk of inadequate cleaning of the wound with usual broad shallow very ugly dog bite. Over joints like on the hand a notable exception.
The possible fail here was that puncture wounds look less bad but are the bad ones that need major effort to adequately irrigate and do warrant a course of prophylactic antibiotics.
Best wishes for an unremarkable course from here.
And for all - the cat bite might not look bad, often does not, but it will be more likely a deep puncture. Go in for those.
Reaching through a fence at dogs is a risky enterprise – you’re crossing a boundary line that may be much more important to the dog than it looks like to you. In general, unless they know well all the dogs behind the fence, and/or are very good at reading dog behavior and move very slowly, that is something that people shouldn’t do (though of course the particular child may never have been told that; a lot of people don’t understand it).
Having said that: seems like that particular dog (the one that bit) needs to be under a lot better control. Double fence and warning signs, maybe?
Is this just less known among the general public in the U.S.? Ask 100 Americans what they think of when you say “tetanus”, and 99 will for sure say “rusty nail” (I did know, at least, that rust itself doesn’t cause tetanus).
I’ve had many cat scratches and bites. They never fail to get infected. Got treatment and got better.
I’ve only had one dog bite that went south on me. And that dog had not been vaccinated for rabies. It was a terrible ordeal.
Again, prompt treatment and I got well quickly.
It does bug me, I get the reticence to over-prescribe antibiotics, its for very very good reasons, but seriously when you have a kid obviously at risk of a bacterial infection, just give them bloody antibiotics.
I went through a similar thing with my daughter, who is extremely medically fragile (and has been in the ICU numerous times with respiratory infections) and her doc refused to prescribe antibiotics for what had all the signs of a secondary infection (she got a respiratory bug, seemed to be getting better, but then suddenly got worse again a few days later). Though to really rub salt in the wound, I turned up to my regular checkup with a slight lingering cough (as a healthy middle aged man) and immediately got prescribed antibiotics without asking for them.
I don’t think so (but I’m not a doctor, maybe there are circumstances where giving antibiotics straight away, rather than when they see a doctor at the hospital,is important?), but its a doctor we are talking about here, right? They took the kid to a doctor and they didn’t give antibiotics. It was my daughters pediatrician (equivalent of a GP in the UK, and maybe Oz too?) who refused to give her antibiotics.
FWIW it was a nurse, or a nurse practitioner they are called in the US, who immediately gave me prescription for antibiotics (I’ve never actually seen the doctor who is nominally “my doctor”, only the NP. It bugs me a little, given how much everything costs in the US, but not enough to cause a fuss for myself, I would call bs if my kids doctors tried that, however).
Ah I see, I didn’t see that. Yeah I don’t think expecting them to give antibiotics is reasonable. Still not particularly good care from the paramedics, though.
I’ve always been taught any dog bite that actually breaks the skin requires going to A+E (I was trying to convince my wife’s friend to go to urgent care when her stepdads dog bit her to the point of bleeding, just the other day)
