Ward round--crocodile bites in Malawi: microbiology and surgical management

• Published in: Malawi medical journal Vol. 21; no. 1; pp. 29 - 31
• Main Authors: Wamisho, Biruk L, Bates, Jes, Tompkins, Marc, Islam, Raneem, Nyamulani, Noha, Ngulube, Chistopher, Mkandawire, Nyengo C
• Format: Journal Article
• Language: English
• Published: Malawi The Medical Association Of Malawi 01.03.2009
• Subjects: Adolescent; Alligators and Crocodiles - microbiology; Amputation; Animals; Anti-Bacterial Agents - therapeutic use; Bites and Stings - drug therapy; Bites and Stings - microbiology; Bites and Stings - surgery; Case Reports; Child; Debridement; Female; Gram-Negative Anaerobic Bacteria; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - etiology; Gram-Negative Bacterial Infections - therapy; Humans; Malawi; Male; Middle Aged; Mouth - microbiology; Wound Infection - microbiology; Wound Infection - pathology; Wound Infection - therapy; Malawi
• ISSN: 1995-7262; 1995-7262; 1995-7270
• DOI: 10.4314/mmj.v21i1.10986

We present a case series of 5 patients admitted over 5 months to Queen Elizabeth Central Hospital who had sustained injuries from a crocodile bite. Three patients required amputation of a limb. The severe soft tissue injury associated with a crocodile bite and the unusual normal oral flora of the crocodile create challenges in treatment. Progressive tissue destruction and haemolysis are complications of such infected wounds. An antibiotic regime is recommended that covers gram negative rods, anaerobes and may include doxycycline, as well as the need to have a low threshold for early amputation.