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EDITORIALS: Fionna Moore "I've just been bitten by a dog" BMJ 1997; 314: 88 [Full text]

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Hindsight

Ernest M. Fischer   (25 October 2003)

Hindsight 25 October 2003
Ernest M. Fischer, none Brian Head Resort 84719 Send response to journal: Re: Hindsight	I can testify to the need for antibiotic treatment following even a small dog bite - from one's own animal. A year and a half ago, I reported to an ER after suddenly experiencing shaking chills, nausea, diarrhea and a degree of disorientation. I noted a fever of 105 F. After a brief examination - that included the notice of animal bites to both my hands - I was given Tylenol and lactated Ringer's. With the fever reduced to 100 F, I was sent home with instructions to return the following day if I did not feel any better. The next morning my fever was back up and my skin was mottled. My fingers and toes were cold and felt a bit numb. Upon returning to the ER, I was admitted and "observed" for four hours while the purple blotching and cold, numb extremities worsened. It was decided that I might be septic and I was moved to the ICU. By that evening, a rapidly dropping platelet count and blood pressure had me on a flight to a larger receiving center. The sepsis turned out to be C. Canimorsus. It had triggered both TTP and DIC. Appropriate antibiotics and plasmapheresis (eight times) saved my life and vital organs, but not my lower legs and fingers. I have to wonder if this scenario might have been avoidable. Competing interests: None declared