They represented particularly challenging cases unique from those seen with dog and snake bites. The patients ranged in age from six to 42, and all but one was participating in food-gathering or guarding activity at the time. Given the type and variety of animals involved in
the attacks, and the potential for future attacks in a setting of increasing proximity of humans to wild animal natural habitat, the management and outcomes of these MLN2238 order remarkable cases were documented to guide future treatment of similar cases. Common themes of tetanus, rabies, and antibiotic treatment for all patients were emphasized. Case Presentations/Results Vervet Monkey A 6-year-old male was attacked by a vervet monkey while playing outside in a rural village. The monkey primarily attacked his face, tearing the soft tissue of his right cheek and mandibular area and exposing his teeth. The patient presented to an outside hospital, where the wounds were cleaned and pressure applied for hemostasis. He was transferred to the Casualty Ward of our hospital six hours after injury,
where a trauma survey revealed no other injuries. His vital signs were normal. He received intravenous ceftriaxone and metronidazole. GANT61 purchase On the surgical ward, he received tetanus toxoid and rabies post-exposure prophylaxis. His wound was cleaned and dressed with moist gauze. Given the large amount of soft tissue loss suffered in the injury and the difficulty in performing a flap coverage operation in our resource-limited setting, the decision was made to allow the patient to granulate his wounds. When adequate granulation was achieved after two months, the patient
was taken to the operating theatre for reconstruction of his upper lip wound. Partial closure was achieved. However, the patient did regain the ability to chew and swallow his food; his ability to control saliva remained partially impaired. He maintained appropriate nutrition and has suffered no other complications of his attack or unrelated P-type ATPase illnesses. He will be referred to a specialist center for definitive closure and reconstruction by plastic surgery. Hyena A 27-year-old female who was retrieving water in her semi-rural village suffered an unprovoked attack by a hyena. Given the relative proximity of her village to selleck Mwanza City, she was brought to our Casualty Ward four hours after her attack, where trauma survey revealed only soft tissue injuries to her face, left hand, and left elbow region. She was hemodynamically normal. She was admitted to the surgery ward and administered intravenous metronidazole and ceftriaxone, tetanus toxoid, and rabies post-exposure prophylaxis. Unlike the pediatric patient, this female patient suffered only disruption of skin lines and no loss of soft tissue.