Bite Injuries: "Friendly Dog" Syndrome

The wounds on the back of this boy's head resulted from an encounter with his neighbor's dog. The youngster's anxious parents brought him in for evaluation 1 hour after he was bitten. The bites were irrigated with saline, and the boy was given an intramuscular injection of ceftriazone. Amoxicillin-clavulanate was prescribed to prevent infection with streptococci, staphylococci, Pasteurella organisms, and anaerobes. A booster dose of tetanus and diphtheria toxoids was given.

At reexamination 3 days later, the child was afebrile, there was no purulent discharge from the healing wounds, and he said that he felt fine. Follow-up at 1 week was uneventful. The parents were assured by the dog's owners that the animal had been immunized for rabies.

Every year, at least 10 children die of dog bites.¹ Most biting dogs are not strays and are known to the victim and his or her family.

(Case and photograph courtesy of William B. Wadlington, MD.)