Dog bite-associated pathogens: advances in pathogenic mechanisms and systemic clinical consequences in humans

Dog bites are a common cause of injury worldwide and constitute a major public health challenge. In addition to mechanical trauma, they inoculate wounds with complex polymicrobial communities derived from the canine oral microbiota and, in rabies-endemic regions, may transmit rabies virus (RABV), leading to clinical outcomes ranging from localized wound infection to fulminant systemic disease and fatal encephalitis. This review summarizes recent advances in the microbiological profiles, pathogenic mechanisms, and systemic consequences of dog bite-associated infections in humans, integrating evidence from human and veterinary medicine within a One Health framework. Key bacterial pathogens include Pasteurella multocida (P. multocida), Capnocytophaga canimorsus (C. canimorsus), staphylococci, streptococci, and anaerobes, which can cause cellulitis, abscesses, necrotizing soft tissue infection, sepsis, meningitis, and endocarditis through tissue invasion, toxin production, and immune evasion. RABV remains the most devastating consequence of dog bites, with an almost universally fatal outcome after symptom onset, driven by glycoprotein-mediated neuronal entry, retrograde axonal transport, and profound evasion of host immune responses. Children, older adults, and immunocompromised individuals bear a disproportionate burden of severe disease. Reducing dog bite-associated morbidity and mortality requires coordinated progress in wound management, rapid molecular diagnostics, rational antimicrobial use, canine vaccination, and timely rabies post-exposure prophylaxis, underscoring the critical value of a One Health strategy.