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Human bite infection risk — MCCQE Part 1 MCQ

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ModerateWoundsHuman bite infection riskMCCQE Part 1

30-year-old man presents with a clenched-fist injury after a fight. There is a small laceration over the MCP joint and pain on extension. Which of the following is the most appropriate next step?

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Correct answer: B — Irrigate, assess tendon/joint involvement, give appropriate antibiotics and surgical/hand review

Irrigate, assess tendon/joint involvement, give appropriate antibiotics and surgical/hand review is best because clenched-fist wounds can penetrate joint/tendon and seed oral flora. Discharge with oral analgesia only is suboptimal because analgesia alone may mask a surgical emergency; Delay surgical assessment until routine clinic is suboptimal because time-sensitive surgical presentations require urgent assessment; Treat with laxatives or antacids as sole therapy is suboptimal because a benign gastrointestinal explanation does not account for the red flags; Perform an invasive bedside procedure without imaging or senior input is suboptimal because invasive treatment can worsen outcomes when anatomy or diagnosis is uncertain. These injuries look deceptively small.

Reference: Canadian emergency medicine guidance