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The term “mammal bite” refers to any bite injury inflicted by any type of mammal, including felines, canines, rodents, and primates (monkeys, apes, and humans). Bites are classified based on the type of trauma, namely:
- Lacerations: cuts with jagged edges
- Abrasions: scrapes produced by friction between a body part and rough surfaces
- Punctures: something has passed through the skin
- Avulsions: wounds with flaps
- Contusions: wounds in which blood vessels have been injured resulting in blood collecting outside blood vessels
Bite trauma also is classified according to severity, which tends to depend on the strength and anatomy of the jaw of the biting animal, the site of the bite on the victim’s body, and the aggressiveness of the attack. Whereas venomous animals usually are not mammals, the problems with mammal bites relate to the physical effect of the bite and to infections that the victim can receive from the attacking animal’s mouth.
Since pregnant women are more often at home than working in a zoo or a circus, the most common mammal bite scenario during pregnancy is a bite from a pet, such as a cat or dog. Bites from rodents also are not uncommon during pregnancy, particularly among women who work with laboratory rodents.
The biggest concern about bites during pregnancy, especially cat bites, is that you will develop an infection.
Eighty-five to ninety percent of mammal bite injuries come from dogs; in a typical community, such bites account for about 1 percent of all visits to the emergency department. Although dogs bite men about twice as often as they bite women, women are victims of cat bites twice as often as men are, and so cat bites are a likely scenario during pregnancy. Most of the remaining mammal bites suffered by humans come from rodents and from other humans. Less common for women whether pregnant or not are bites from pigs, monkeys, apes, camels, raccoons, ferrets, bats, and minks. However, common sense is appropriate. If you work in lab, farm, or zoo, your risk of getting bit is higher compared with a woman who works in an office or other environment. Also, as you may imagine, the risk of a mammal bite is much higher among pet owners than among people who do not have pets; in fact, 66 to 90 percent of dog bites happen to people who own or live with a dog. And so, a typical pregnancy bite scenario occurs at home, or when a woman is out walking her pet.
If you have been bitten, the examiner will want to check if there is a bone fracture, an injury to soft tissue, or other damage that may require surgical procedures, such as suturing (stitches), debridement, drainage, or reconstruction. Doctors will likely order X-rays or other types of imaging. You should not worry about ionizing radiation affecting the baby, as the radiation dosage that you’ll receive from simple radiographs is not dangerous, whereas failure to recognize a bone fracture can be quite dangerous, both to you and the baby. Also in the course of the workup, doctors may collect fluid from the wound and draw other types of samples from the wound to test for bacterial infections and viral infections, such as human immunodeficiency virus (HIV), hepatitis B, and hepatitis C virus. Blood samples may be taken for basic tests, such as a complete blood count (CBC) with differential (quantifying the different types of white blood cells) and for tests for inflammation, such as C-reactive protein and erythrocyte sedimentation rate (ESR).
The biggest concern about bites during pregnancy, especially cat bites, is that you will develop an infection. Thirty to fifty percent of cat bites, 5 to 25 percent of dog bites, and 15 to 25 percent of human bites become infected. Infection is most likely from bites to the hand. Although fairly rare, infections from mammal bites can spread from the bite site to become a systemic infection. This happens in cases of rabies (a viral infection from rabid animals), cat-scratch disease, herpes virus B, brucellosis, tularemia, and rat-bite fever.
Tetanus is an example of a disease that affects the entire body, and that can occur as a result of a mammal bite. In contrast with infections, tetanus is the result of a toxin entering the body. Microorganisms produce the toxin, but it’s the toxin that enters the body, not the microorganisms. Human bites can cause infections such as HIV, hepatitis B or C, and a bacterial infection called Treponema pallidum, which causes syphilis. These systemic infections can have severe, even fatal, consequences. Furthermore, HIV, hepatitis B and C, and syphilis infections can spread to the fetus, either during pregnancy or delivery, while maternal brucellosis can lead to spontaneous abortion (miscarriage), premature birth, or chorioamnionitis, an infection of the fluid and sac, and fetal death. On the other hand, certain other systemic infections such as cat scratch disease produce more mild effects.
Bites from certain mammals, especially cats and humans, carry a high risk of infection, so antibiotic medication generally is prescribed for 3 to 5 days. The main medication regimen is called amoxicillin–clavulanic acid, which is safe during pregnancy and also during breastfeeding. Safe alternatives to amoxicillin-clavulanic acid include clindamycin, and, in the second and third trimesters, a medicine called metronidazole.
Often with dog bites, antibiotics can be avoided and the main therapy is good wound management, which means cleaning the bite, first with soap and water and a fine pore sponge, and then with saline, water, or a dilute solution of povidone-iodine. You also should remove dirt and other foreign materials carefully, if they do not come off with water, and then later your doctor may decide to debride damaged tissue, which means remove certain parts of the tissue.