Camel Bite Associated with Depressed Skull Fracture with Rapidly Spreading Subgaleal Cellulitis. (25th May 2020)

• Record Type: Journal Article
• Authors: Al-Umran, Shaymaa; Abdulfattah, Ahmad; Alabbas, Faisal; Al-Jehani, Hosam
• Other Names: Sánchez Pérez Hector Javier Academic Editor.
• Is Part Of: Case reports in infectious diseases. Volume 2020(2020)
• Publication Date: 2020-05-25
• Subjects: Communicable diseases -- Periodicals; Communicable diseases -- Case studies -- Periodicals; Communicable Diseases; Infectious Disease Medicine; Communicable diseases; Electronic journals; Periodicals; Case studies; Periodicals; 616.9
• DOI: 10.1155/2020/8393059
• Languages: English
• ISSNs: 2090-6625

Abstract

Abstract : Camel bite represents a minimal proportion, and most of them are from the Middle East countries. Their infectious potential is poorly understood, and the guidelines for antimicrobial treatment are not well developed. We describe a 40-year-old male, who works as a camel herder and was bitten by a camel while he was tying it down which led to a unilateral depressed skull fracture and multiple bilateral teeth-puncture wounds in the scalp. He arrived to our emergency department 3 hours after injury. All the wounds were dry and the skin around them was healthy looking with no subcutaneous collections. CT scan of the head showed depressed skull fracture on the left temporal region. Within 12 hours, the patient developed spreading cellulitis in the scalp. This necessitated an urgent surgical intervention. The added challenge is the presence of a dural breach. Our patient presented a challenge at several levels. He presented early with clean puncture wounds that were treated according to the most agreed upon guidelines. But our novel finding of rapidly spreading cellulitis requires alteration of recommendation towards more aggressive therapeutic attitude including early surgical intervention, especially for those patients suspected of a dural tear with the depressed skull fracture, even if treated with appropriate antibiotics.