Management of Wild, Noncanine Mammalian Attacks Complicated by Bacterial Infection: A Case Report and Systematic...

Patients that sustain wild animal-related injuries face a distinct treatment and rehabilitation trajectory that are uncommon to other trauma scenarios. These injuries are unique due to the combination of cutting, penetrating, crushing, tearing, falling, and blunt forces involved. The polymicrobial environment transmitted by wild animals can perpetuate local or systemic infection, compounding the risk for treatment complications, morbidity, and mortality.

In this review, current literature on the complications of bacterial infections following wild, noncanine mammalian attacks is summarized. A case of a young woman who sustained injuries and infective complications following a black bear attack is also presented here and related to current literature. The literature review was performed on PubMed following PRISMA guidelines to identify case reports on such attacks. Cases involving attacks by domesticated animals, canines, or nonmammals were excluded.

Thirty-one articles met the inclusion criteria. Twenty-two articles are case reports and nine are case series. The results were then compiled to look for trends in the bacteriology of wounds inflicted by wild, noncanine mammals and how infections were treated in each case.

Most patients were treated with surgical debridement, tetanus vaccination, rabies vaccination, and empiric, rather than definitive, antibiotic regimens. Wound cultures were not collected in over half of the articles reviewed, resulting in prolonged infectious sequelae. Through this review, the distinct considerations required for providing care to victims of wild, noncanine mammalian attacks is elucidated.