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Cat bite infections of the hand: assessment of morbidity and predictors of severe infection.

PURPOSE: To assess the overall morbidity of cat bites to the hand and identify risk factors for hospitalization after such an injury.

METHODS: All patients recently treated at our institution for cat bite injuries to the hand were retrospectively reviewed. We identified 193 patients in a 3-year period between January 1, 2009, and December 31, 2011. Patient demographics, medical history, physical examination findings, laboratory values, and long-term follow-up data were collected. Univariate and multivariate statistical regression were used to analyze the data.

RESULTS: Thirty percent (n = 57) of patients with cat bites to the hand were hospitalized. The average length of stay for these patients was 3.2 days. Of the hospitalized patients, 67% (n = 38) underwent irrigation and debridement, with 8 patients requiring more than 1 operation. Complications were common among these patients. Risk factors associated with hospitalization included smoking, immunocompromised state, and location of bite over a joint or tendon sheath. Physical examination findings of erythema and swelling at presentation were also associated with increased risk of hospitalization. Time from bite to presentation, white blood cell count, erythrocyte sedimentation rate, and C-reactive protein values at presentation were not associated with hospitalization.

CONCLUSIONS: Cat bite injuries to the hand can progress to serious infection. The treatment of such infections often requires hospitalization, intravenous antibiotic therapy, and operative treatment. Clinical findings suggestive of the need for hospitalization include location of the bite over a joint or tendon sheath, erythema, pain, and swelling. These findings should increase concern for a severe infection and warrant hospitalization and urgent consultation with a hand surgeon.


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