amoxicillin-potassium-clavulanate-combination and Hand-Injuries

Human bites to the hand or penetrating injuries contaminated with saliva can be a source of aggressive infection and debilitating injury. These types of injuries may also be a mode for the transmission of disease, notably hepatitis B. Dental personnel have an increased risk of experiencing bite injuries and should understand the general principles of appropriate management. Staphylococcal or streptococcal species are often associated with infected bite injuries, and amoxicillin and clavulanate are currently advised for prophylaxis. Wound cleansing and careful monitoring, combined with appropriate prophylaxis, are the mainstays of treatment.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bacterial Infections; Bites, Human; Clavulanic Acids; Dentistry; Drug Therapy, Combination; Hand Injuries; Humans; Occupational Diseases

In many of Africa's rural areas, snakebite victims often resort to traditional healers for first line treatment. This may be source of infectious complications. We report a case of generalized tetanus which occured after 15 days in a 13-years old boy who had applied a traditional, plant-based concoction on a snake bite. He presented with trismus, generalized contractures and fever extended musculo-aponevrotic necrosis of the right upper limb, without loss of consciousness. The only accompanying biological sign was an increased leukocyte count (11,200/mm3) with a predominance of neutrophils (84%). Platelets count, creatinin and AST/ALT titers and haemostasis were all normal, as was the radiogram of the right hand. The clinical outcome was favourable after 3 weeks hopital care (antibiotic, muscle relaxants, antitetanus serotherapy and local wounds care). This clinical observation shows that traditional care for snake bite wounds can be an entry point for tetanus. Appropriate treatment of snake bites in a hospital setting is of the utmost importance, in addition to vaccination against tetanus, in order to reduce the incidence of tetanus in African countries.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Combined Modality Therapy; Cote d'Ivoire; Diazepam; Hand Injuries; Humans; Hydrocortisone; Immunization, Secondary; Male; Medicine, African Traditional; Netilmicin; Phytotherapy; Snake Bites; Tetanus; Tetanus Antitoxin; Tetanus Toxoid; Wound Infection

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Bites, Human; Ceftriaxone; Debridement; Drug Therapy, Combination; Hand Injuries; Humans; Male; Metronidazole; Tetanus; Therapeutic Irrigation