As the remote bear habitat is encroached by human development, there has been an increase in bear encounters, with a resultant increase in attacks. The oral flora of bears generally reflects their diet, which is high in plant matter, and occasional meat or carrion. Organisms that have been most commonly isolated from the oral cavities of black bears include Streptococcus spp., Staphylococcus spp., E. coli and Enterobacter spp.[67–69] With regards to actual wound infections from bear bites, there are few reports. Kunimoto et al. reported on a hunter who, among other injuries, was bitten on the head by a grizzly bear. The patient was originally given empiric antibiotics (cefazolin and metronidazole), and cultures were obtained 12 h after the attack, but there was still polymicrobial growth, including Serratia spp., Aeromonas hydrophila, Bacillus cereus and Enterococcus spp. No anaerobes were identified. Another case report of bear bite wound infection was reported in a man who sustained several bites from a brown bear. The infected thigh wound grew Mycobacterium fortuitum as well as Streptococcus sanguis, Neisseria sicca and Bacillus spp. Liu et al. reported on a 4-year-old who developed a chronic osteomyelitis after being bitten by a bear in captivity. The wound grew Prevotella oralis, Streptococcus viridans and Propionibacteria acnes. Although there are no specific recommendations regarding empiric therapy after bear bite, Floyd et al. recommended coverage for Gram positives with either a PCN or first-generation cephalosporin, and further modification based on culture results. However, based on the few case reports of actual bear bite infection, it would seem reasonable to also include broader coverage for Gram-negative organisms.
Expert Rev Anti Infect Ther. 2011;9(2):215-226. © 2011 Expert Reviews Ltd.
Cite this: Animal Bite-associated Infections - Medscape - Feb 01, 2011.