Centipede envenomation

Five episodes of envenomation by centipedes in 2 patients are reported. These arthropods are fast-moving, frightening in appearance to some, and may display aggressive behavior. However, stings from these centipedes, like most found worldwide, caused no serious morbidity or mortality. Common effects included intense local pain, erythema, induration, and necrosis, as well as mild constitutional symptoms. All resolved without sequelae. Treatment included pain control, wound care, and tetanus immunization.

The anatomy of a shark attack: a case report and review of the literature

Shark attacks are rare but are associated with a high morbidity and significant mortality. We report the case of a patient's survival from a shark attack and their subsequent emergency medical and surgical management. Using data from the International Shark Attack File, we review the worldwide distribution and incidence of shark attack. A review of the world literature examines the features which make shark attacks unique pathological processes. We offer suggestions for strategies of management of shark attack, and techniques for avoiding adverse outcomes in human encounters with these endangered creatures.

[Animal bites caused by a song bird?]

The report describes a case of post-mortem scavenging by a songbird. A married couple had opened the cage of an astrild (finch) prior to their joint death. The body of the wife showed unusual patchy epidermal lesions on parts of the body not covered by the clothing, which were obviously caused by the songbird. According to the observations made by Roll and Rous they are attributable to "pecking and pulling". The behaviour of the bird was most probably due to lack of fluid.

Aquatic antagonists: lionfish stings

Although lionfish can be found in all the oceans, the highest incidences of human stings appear to be in the tropics, especially in the Indo-Pacific area and Mediterranean Sea. The recent interest in tropical fish aquaria has expanded the geographic range of the stings of these animals.

Sea-urchin granuloma: histologic profile. A pathologic study of 50 biopsies

BACKGROUND

Sea-urchin granuloma is a chronic granulomatous skin lesion caused by injury with sea-urchin spines. Frequently these lesions occur on the hands and develop several months after the initial injury. Classified as an allergic foreign-body reaction, their most common histological pattern resembles sarcoid. The purpose of this study was to evaluate the light microscopic features of biopsies from lesions clinically diagnosed of sea-urchin granolomas.

METHODS

We retrospectively reviewed 50 biopsy specimens corresponding to 35 patients with sea-urchin granulomas. These lesions were caused by injuries with the spines of the sea-urchin Paracentrotus lividus. Data were collected between 1990 and 1999 from patients in the seashore of Galicia (NW Atlantic coast, Spain).

RESULTS

The cohort consisted of 35 patients (31 males, 4 females), with a median age of 35 years (range 14-60 years). The median duration of the disease was 7.5 months (range 2-60 months). We identified different histopathologic patterns. A granulomatous reaction was observed in 39 biopsies (78%). In 70% corresponding to 35 biopsies this granulomatous reaction was predominant. Foreign-body, sarcoidal, tuberculoid, necrobiotic and suppurative granulomas were identified. The remaining 15 biopsies (30%) showed a predominant inflammatory reaction with features of non-specific chronic inflammation or suppurative dermatitis. A panel of histopathologic features, including epidermal and dermal changes were evaluated. Presence of focal necrosis and microabscesses were common findings. In 50% of our specimens we found umbilication and/or perforation. Additional features included the presence of inclusion epidermoid cysts in four cases and squamous syringometaplasia in one case.

CONCLUSIONS

Our observations suggest that sea-urchin granuloma span a wide morphologic spectrum. A granulomatous inflammatory reaction was predominant, with the foreign body and sarcoidal types the most frequent patterns. Other histopathologic patterns with non granulomatous inflammation can be noted. Some features, such as the frequency of perforation and the presence of necrobiotic granulomas have not previously been recognized in the literature.

[Eyelid and facial injuries due to dog bites]

BACKGROUND

Head und neck injuries of children are mistly due to dog bite.

PATIENTS AND METHODS

During the 10-year interval from 1990 to 2000 sixteen patients suffering from dog bite injuries were seen in our department. Age, gender, pattern of ocular and periocular wounds, surgical management and long-term damage were analyzed.

RESULTS

Medial lower eyelid injuries with lacrimal duct involvement were most common. Ten victims were younger than four years. 87% of the dogs belonged to the family and friends of the patients. Two localized infections and no systemic infection were seen.

CONCLUSION

Primate microsurgical wound repair leads to a satisfying functional, morphological, and esthetic long-term result.

Composite grafting and hyperbaric oxygen therapy in pediatric nasal tip reconstruction after avulsive dog-bite injury

It is estimated that more than four million people are bitten by dogs in the United States each year. The majority of such injuries are minor, and their treatment does not usually require surgical consultation. However, the authors report a case in which a Rottweiler inflicted a mutilating nasal tip/alar rim avulsion on a 5-year-old boy. They report their experience with immediate reconstruction of the nasal defect using a large ipsilateral auricular cartilage composite graft (crus helix). Adjunctive hyperbaric oxygen therapy (without sedation or anesthesia) was used to maximize the stimulus for graft revascularization. Reconstructive goals were achieved while avoiding the need for a central facial donor site defect.

Hyperbaric oxygen therapy in the treatment of soft tissue necrosis resulting from a stingray puncture

Necrotizing soft tissue processes of the foot secondary to an acute stingray envenomation can be a challenge to manage. Very little is reported in the orthopaedic literature to aid the practicing surgeon faced with this problem. In this case report, we describe the wound management and team approach employed in this patient's care, including the indications for hyperbaric oxygen therapy, which, in this case, was ultimately successful.

[Early post-mortem animal bites after suicidal gunshot wound to the head of a police dog handler]

A 41-year-old police officer committed suicide in his office by firing a contact shot to the left temple. When the body was found 12 hours later, the German shepherd dog the officer had been in charge of had caused considerable damage on the lower half of the face and the adjacent parts of the neck. The clothing of the suicide was undamaged. Blood traces in the shape of paws were found at the place of death. The wound margins of the postmortem animal injury were nicked and jagged by the canine teeth. The entrance and exit wounds were not affected by the soft tissue defect. The findings gathered are discussed in reference to the relevant literature.

Basic instinct in a feline

Reported cases in Europe of large felines attacking humans are rare. Recently, in France, a man was attacked in an animal park by a tigress he had raised. He received fatal cervical wounds. This case of death by bites and lacerations, together with others in the recent international literature, underline the hereditary ferocity of such felines and the way in which they prefer to inflict lesions to the neck.

Avian mite bites acquired from a new source--pet gerbils: report of 2 cases and review of the literature

BACKGROUND

Cutaneous manifestations of avian mite bites are not well recognized by physicians or patients. Clinical signs and symptoms are usually caused by bites from avian mites that have infested domestic poultry or birds nesting in or near human habitation. This report details 2 cases of pruritic papules acquired from avian mites that had infested pet gerbils and reviews the dermatologic literature about avian mites.

OBSERVATIONS

An 11-year-old boy and an unrelated 10-year-old girl each had mysterious, pruritic papules for many months before their pet gerbils were found to be infested with Ornithonyssus sylviarum (the northern fowl mite) and Dermanyssus gallinae (the chicken mite), respectively. Symptoms resolved when the gerbils were removed from the home.

CONCLUSIONS

Because infestation of pet gerbils with avian mites has never been reported, cases of avian mite bites and dermatitis may have gone unrecognized or misdiagnosed. Inquiry about ownership of pet gerbils may be helpful in patients with mysterious bites.

The toxicology of Heloderma suspectum: the Gila monster

The biotoxicology of Heloderma suspectum, the Gila monster, is presented in order to complement the homeopathic provings.

Dog bites in New York City

The purpose of this review is to characterize the public health problem of dog bites in New York City. Dog bites represent a major source of morbidity, mortality, disability, and health care cost in the United States. The most severe injuries are frequently referred to the plastic surgeon. The authors have recently treated several severe cases of unprovoked dog attacks in children. To characterize the dog bite problem in New York City, data were obtained for 1998 from the New York City Department of Health. During that year, 6568 bites were reported by the mandated physician reporters in the five boroughs of New York City. The upper extremities, lower extremities, and face were predominantly affected. The peak incidence occurred during the summer months and in children ages 7 to 9 years old. Preventive measures are discussed.

Injuries to avian researchers at Palmer Station, Antarctica from penguins, giant petrels, and skuas

This paper describes 5 cases of injury to seabird researchers between 1996 and 1999 at Palmer Station, Antarctica. The injuries were inflicted by 3 seabird species: the Adelie penguin (Pygoscelis adeliae); the southern giant petrel (Macronectes giganteus); and the brown skua (Catharacta lonnbergi). All injured parties were biologic researchers with previous field experience working under National Science Foundation research grants; all sought medical evaluation and treatment voluntarily. The nature and frequency of such injuries seems not to have been greatly reported in the medical literature. Although these cases were largely soft tissue injuries that healed without serious complications, the possibility of exotic infections is considered. We have dubbed this constellation of injuries AVES (Antarctic Vogel [German for bird] Encounter Syndrome).

Persian leopard (Panthera pardus) attack in Oklahoma: case report

The authors report a fatal case of a Persian leopard (Panthera pardus) attack in an animal sanctuary in Oklahoma. The victim was a 53-year-old Costa Rican woman who was attempting to feed the animal when she was attacked and killed. Autopsy, radiography, fingerprint analysis, microbiologic cultures, and dental impressions were used to evaluate the case. These simple techniques can be applied to similar cases involving wild and domestic animal attacks.

Pathologic features of fatal shark attacks

To examine the pattern of injuries in cases of fatal shark attack in South Australian waters, the authors examined the files of their institution for all cases of shark attack in which full autopsies had been performed over the past 25 years, from 1974 to 1998. Of the seven deaths attributed to shark attack during this period, full autopsies were performed in only two cases. In the remaining five cases, bodies either had not been found or were incomplete. Case 1 was a 27-year-old male surfer who had been attacked by a shark. At autopsy, the main areas of injury involved the right thigh, which displayed characteristic teeth marks, extensive soft tissue damage, and incision of the femoral artery. There were also incised wounds of the right wrist. Bony injury was minimal, and no shark teeth were recovered. Case 2 was a 26-year-old male diver who had been attacked by a shark. At autopsy, the main areas of injury involved the left thigh and lower leg, which displayed characteristic teeth marks, extensive soft tissue damage, and incised wounds of the femoral artery and vein. There was also soft tissue trauma to the left wrist, with transection of the radial artery and vein. Bony injury was minimal, and no shark teeth were recovered. In both cases, death resulted from exsanguination following a similar pattern of soft tissue and vascular damage to a leg and arm. This type of injury is in keeping with predator attack from underneath or behind, with the most severe injuries involving one leg. Less severe injuries to the arms may have occurred during the ensuing struggle. Reconstruction of the damaged limb in case 2 by sewing together skin, soft tissue, and muscle bundles not only revealed that no soft tissue was missing but also gave a clearer picture of the pattern of teeth marks, direction of the attack, and species of predator.

The medusa stage of the coronate scyphomedusa Linuche unguiculata ('thimble jellyfish') can cause seabather's eruption

Adult Linuche unguiculata medusae cause seabather's eruption just like that animal's larval form. This observation explains the wide seasonal incidence and the fact that lesions can appear on exposed skin.

[Postmortem dog bites after sexually motivated homicide with multiple stab wounds--differential diagnostic aspects]

The body of a 20-year-old woman that had undergone significant putrefaction was found lying on the bed of her apartment in a supine position. The legs were straddled and apart from a T-shirt, she was naked. The inner side of the right thigh showed a circumscribed 20 cm x 40 cm defect exposing the underlying muscles. The wound margin was ragged and superficial scratch-type abrasions were found in the vicinity of the injury margin. The investigating police officers classified the injuries to be caused postmortem by a crossbreed dog that was inside the apartment. No other signs of external force were found on the body at the death scene and due to the previous history of the deceased, a drug death was assumed. Autopsy revealed 13 vital stab wounds in the neck and aspiration of blood in the lungs as well as signs of manual strangulation. The observed coincidence of injuries due to postmortem animal depredation and stab wounds, although in different localization, can be regarded as a rare entity in the light of the literature. The morphological appearance of traumatic injuries due to other causes can be modified by the simultaneous presence of postmortem injuries caused by animals and difficulties can arise concerning the differential diagnosis especially under poor conditions (e.g. advanced putrefaction) at the death scene.

Skin and soft tissue artifacts due to postmortem damage caused by rodents

Five cases of postmortem bite-injuries inflicted by rodents are presented (five males between 41 and 89 years; three cases caused by mice, one case by rats, one case of possible mixed rodent activity by rats and mice). The study presents a spectrum of phenomenological aspects of postmortem artifacts due to rodent activity to fresh skin and soft tissue: the majority of the injuries have a circular appearance. The wound margins are finely serrated with irregular edges and circumscribed 1-2 mm intervals within, partly showing protruding indentations up to 5 mm. Distinct parallel cutaneous lacerations deriving from the biting action of the upper and lower pairs of the rodents incisors are diagnostic for tooth marks of rodent origin but cannot always be found. No claw-induced damage can be found in the skin beyond the wound margins. Areas involved in the present study were: exposed and unprotected parts of the body, such as eyelids, nose and mouth (representing moist parts of the face); and the back of the hands. Postmortem rodent activity may occasionally be expected on clothed and therefore protected parts of the body. The phenomenon of postmortem rodent activity to human bodies can be found indoors especially under circumstances of low socioeconomic settings; outdoors this finding is particularly observed among fatalities among homeless people.

Unusual injury pattern in a case of postmortem animal depredation by a domestic German shepherd

A case is presented of a 38-year-old woman with skeletization of the head, neck, and collar region and a circumscribed 26-cm x 19-cm defect on the left chest with sole removal of the heart through the opened pericardium but undamaged mediastinum and lungs. The injuries showed V-shaped puncture wounds and superficial claw-induced scratches adjacent to the wound margins that have been described as typical for postmortem animal depredation of carnivore origin and derived from postmortem animal damage by the woman's domestic German shepherd. The circumscribed destruction of the left chest with unusual opening of the pericardium is explained by the physiognomy of the muzzle of the German shepherd and differs from previous reports. Any case presented as postmortem animal mutilation should be viewed with skepticism and undergo a full autopsy.

A comparison of bitemark injuries between fatal wolf and domestic dog attacks

Bitemark patterns in adult human victims following a fatal wolf pack attack and a domestic dog pack attack are compared. Both victims exhibited a concentration of wounds to the extremities, left and right torso, but not to the groin or internal organs. The neck and face of the domestic dog attack victim were primary sites of attack while the feral wolf pack victim was spared damage to the neck, but had facial tissue destroyed postmortem. Most punctures were found on the ventral aspect of the domestic victim and dorsal aspect of the feral victim. It is speculated that most wounds were attributable to dominant animals of both packs and in both victims and this suggests a co-ordination of activity between. Differences in bitemark patterns may well have been caused in part by differences in genetics, training, breeding, socialization and impetus of attack between wolves and dogs. Distinct differences in bitemark patterns were found in these two human victims of a wolf and domestic dog attacks.

Benign idiopathic partial epilepsy and brain lesion

A 14-year-old girl had severe head trauma from a dog bite at the age of 9 days. This resulted in extensive brain damage, tetraplegia, mental retardation, and epilepsy. The seizures were of rolandic type, and the EEG showed multifocal sharp waves. The course was benign. The initial diagnosis of a pure symptomatic epilepsy was revised after demonstrating typical benign focal sharp waves in the EEG of the healthy sister. Thus a phenocopy of a benign partial epilepsy by the brain lesion could be excluded with sufficient certainty. This observation allows the conclusion that the genetic disposition underlying the sharp-wave trait characteristic of benign partial epilepsies can be involved also in the pathogenesis of seemingly pure symptomatic epilepsies. EEG studies on siblings of such patients are needed to exclude possible phenocopies.

Lesions of so-called flank biting and necrotic ear syndrome in pigs

Skin lesions were established on the flanks of pigs aged 10 to 12 weeks, in the areas of the ribs, the mid-upper leg, the shoulder and the tuber ischii. Skin lesions on the ear tips, known as porcine necrotic ear syndrome, were detected in weaners throughout the raising period. By the histological examination of 50 samples of skin lesions from the flank, two stages of epidermal and dermal changes were established; the milder stage had epidermal changes with marked acanthosis, rete ridges formed deep in the dermis and mild infiltrates of mononuclear cells in the layers around the capillaries in the dermis; the more severe stage had ulcers, under which there were infiltrates of polymorphonuclear cells. The same histological changes were observed in 23 samples of skin lesions taken from the tips of ears with necrotic ear syndrome. On healthy skin from the flank and ear tip, micrococci were the dominant organism, whereas on skin lesions from both the affected areas staphylococci were dominant. Since the histological lesions on the flanks were identical to those in necrotic ear syndrome, which has been associated with Staphylococcus hyicus infection, the pathogenesis of the lesions on the flanks is probably the same.

[Death caused by "attack dog" bites. A contribution to current discussion]

Two cases of fatal dog-bite incidents caused by males of the "American Staffordshire terrier" breed currently known as "fighting dogs" are reported. Both happened in elderly women, one of them handicapped. Reconstruction of the accidents revealed some peculiar characteristics of these dogs, namely the ability to attack undesirably and forcefully as well as the enormous grip of their jaws. Considerable public attention has been drawn to some breeds which seem to predominate in dog-bite statistics and are summarized as "pit bulls". For the animal behaviourist it is not justifiable to condemn only the dog and blame it solely for damage inflicted. Scientific casework has to encompass the situational background of any case and the animal's holder because there is often a close association between the character of the dog and its human counterpart. Implications of such incidents for public safety policy and forensic science are to be discussed.

Primary repair of dog bites to the face: 40 cases

Dog bites to the face can be life-threatening if major infection occurs, and traditional management consists of wound toilet and debridement, with repair only when the possibility of infection has been eliminated. Surgical opinion is now swinging towards earlier repair. We have analysed retrospectively the outcome of 40 cases that, irrespective of time delay between injury and presentation, underwent primary repair or reconstruction after wound toilet, debridement and administration of prophylactic antibiotics. The victims were 17 males and 23 females with ages ranging from 2 to 76 years (mean 25). Median delay between the injury and presentation in the emergency department was 60 minutes (range 7 minutes to 5 days). All patients received surgical treatment within 24 hours of admission, 18 being operated on within 6 hours. 31 had primary repairs and 9 patients had reconstructive procedures with local skin flaps or skin grafts. Primary healing was achieved in all but 2 patients, of whom one developed minor wound infection and one had necrosis of a composite graft. These results support the view that, for dog bites to the face, primary repair is the method of choice.

[Simulation of attempted homicide by dog bite in unconscious state]

It is reported on the unusual event of dog scavenging in an unconscious and intoxicated (alcohol) person. Due to the particular circumstances a case of attempted homicide was primarily suspected. Peculiarities of the case were a small dog (dachshund) as the responsible cause and the survival of the injured woman. Intensive and partly deep wounds due to scavenging were found on both shoulders/upper arms in nearly symmetrical order. Vomit from the dog could be assigned to the unconscious person by DNA typing. The typical morphological features of dog bites and injuries due to scavenging, respectively, and the possible motivation of the animal are discussed.

A human case of tick bite by Ixodes persulcatus

The first case of tick bite by Ixodes persulcatus in Korea is reported. The tick was found on the skin of right lower axilla region of a 60-year-old woman.

Tick infestation of the eyelid

PURPOSE

To report the rare occurrence of tick infestation of the eyelid margin.

METHODS

A 58-year-old woman was initially examined with a small yellow lesion of the left upper eyelid margin that appeared after she felt a sting near her eye. Close examination disclosed an insect body attached to the eyelid margin. En bloc excision of the insect with part of the eyelid was performed.

RESULT

Gross examination of the specimen identified the organism as the nymph stage of a bloated tick of the genus Hyalomma but of an uncertain species.

CONCLUSION

Ticks (Hyalomma) can become embedded in the meibomian gland orifice and manifest as a mass at the eyelid margin.

Aging of bitemarks: a literature review

The aging of bitemarks through the subjective interpretation of visual signs has created an area of controversy in the forensic science community. The healing dynamics of these bite wounds has been insufficiently studied and is poorly understood. A review of the literature related to bitemark aging was undertaken in an effort to summarize the currently published information on this misunderstood subject.

Report on envenomation by a Gila monster (Heloderma suspectum) with a discussion of venom apparatus, clinical findings, and treatment

Human envenomations by Heloderma species are a rare but clinically important medical problem. We report a case of an adult male bitten on the left hand by a 50-cm male, captive specimen of Heloderma suspectum (Gila monster). Immediate signs and symptoms included pain at the bite site radiating into the arm and axilla and swelling of the hand and forearm. Systemic complaints of nausea, diaphoresis, and dizziness (without a decrease in blood pressure) lasted approximately 1 hour, and laboratory studies were normal. The patient's course was uneventful except for persistent hyperesthesia, which eventually abated. Two types of helodermatid bites produce distinct clinical pictures. The chewing bite potentially causes more envenomation than the slashing bite. The venom contains a number of protein and nonprotein components including serotonin, a bradykinin-releasing substance, protease, hyaluronidase, helodermin, and gilatoxin. The clinical presentation of a helodermatid bite can include pain, edema, hypotension, nausea, vomiting, weakness, and diaphoresis. No antivenin is commercially available. Treatment is supportive, and although first aid measures such as suction or compression may impede venom movement, they are unproved. Cryotherapy, tourniquet, and excision are dangerous and should not be used.

Stingray injuries

Stingray injuries to humans are common in warm coastal areas. Wounds have a traumatic (puncture) component and a toxic (envenomation) component. The puncture component is like a stiletto-type knife wound, most often inflicted on the lower leg (waders) or arm (fishermen). Rare puncture injuries to the thorax or abdomen can cause serious injuries and death. Envenomation causes intense pain that is out of proportion to the apparent injury. The pain of stingray envenomation is relieved with hot-water immersion of the injured part, although the exact mechanism for this well-established phenomenon remains unclear. Current recommendations for treating stingray wounds are reviewed.

Stingray injuries

Stingray injuries to humans are common in warm coastal areas. Wounds have a traumatic (puncture) component and a toxic (envenomation) component. The puncture component is like a stiletto-type knife wound, most often inflicted on the lower leg (waders) or arm (fishermen). Rare puncture injuries to the thorax or abdomen can cause serious injuries and death. Envenomation causes intense pain that is out of proportion to the apparent injury. The pain of stingray envenomation is relieved with hot-water immersion of the injured part, although the exact mechanism for this well-established phenomenon remains unclear. Current recommendations for treating stingray wounds are reviewed.

A case of tick bite by a spontaneously retreated Ixodes nipponensis

A 58-year old housewife consulted us about 1 cm sized, dark-brownish, bean-like mass which was dropped spontaneously from indurated skin lesion on her abdomen. The mass was identified morphologically as an engorged female Ixodes nipponensis. Nine days earlier, she had an excursion collecting edible sprouts of wild grass. Spontaneous retreat has been unusual in clinical tick bites in Korea. Fourteen cases of tick bite described in the Korean literature were reviewed briefly in relation to Lyme borreliosis.

A case of envenoming by Portuguese man-of-war from the Brazilian coast

This is an individual case report on envenoming caused by the cnidarian Portuguese man-of-war. The reported local reactions and the clinical symptoms are similar to those already known for Portuguese man-of-war envenoming. As far as we know it is the first clinical case documented for the Brazilian shores.

A fatality and the American mountain lion: bite mark analysis and profile of the offending lion

Attacks on humans by mountain lions have been infrequent in the history of the United States. Of the 64 authenticated attacks since 1890 in North America, there have been 13 fatalities. This paper reports a case of an adult mountain lion which attacked and killed a female jogger during the spring of 1994 in California. The lion left an imprint of its teeth on the victim's chin. The authors used this bite mark to aid authorities in profiling the approximate age and gender of the attacking animal. The authors subsequently utilized bite mark analysis to establish that the lion actually responsible for the attack had been removed from the area.

Identification of Chironex fleckeri envenomation by nematocyst recovery from skin

OBJECTIVE

To prospectively compare two methods of nematocyst retrieval from skin for confirmation of Chironex fleckeri jellyfish envenomation.

PARTICIPANTS AND METHODS

Twenty patients presenting to Royal Darwin Hospital with jellyfish stings. In each, two methods of retrieval of nematocysts from the sting site were tested: scraping the skin with a scalpel blade; and application of transparent sticky tape.

RESULTS

Chironex fleckeri nematocysts were identified in 14/20 patients by scalpel blade scraping and in 17/20 by the sticky tape method. In all patients with scalpel blade scrapings positive for nematocysts, nematocysts were also retrieved by the sticky tape method. Only four patients required narcotic analgesia and none required C. fleckeri antivenom.

CONCLUSIONS

Nematocyst retrieval from skin by a simple sticky tape method is at least as good as scraping with a scalpel blade. Chironex fleckeri causes the majority of jellyfish envenomations presenting to Royal Darwin Hospital.

Analysis of human remains recovered from a shark

Trauma caused by marine scavengers and predators, especially sharks, is not well known. This paper describes the effect of shark attack on human remains. They were found in the stomach of a tiger shark caught by fishermen near Hollywood Beach, Florida. The remains belonged to a white male in his late twenties or early thirties with a stature of 175 cm. The damages to the skeleton and the association of these damages with the behaviours of tiger sharks is also analyzed. The trauma affecting long bones are circular punctures around the epiphyseal ends. Other changes include unique crescent shape grooves horizontal to the shaft of the bone. Although all of the bones are affected, none of them is fractured or crushed, suggesting that the body parts are first dismembered and then swallowed and digested.

Cultivation of Borrelia burgdorferi from human tick bite sites: a guide to the risk of infection

BACKGROUND

The risk of acquiring Lyme disease has been evaluated by xenodiagnostic procedures with laboratory strains of Borrelia burgdorferi and laboratory-reared Ixodes ticks, or by clinical trials in which diagnosis was based on clinical findings, culture, or serologic tests.

OBJECTIVE

Our purpose was to determine the risk of infection from tick bites in a natural setting in which wild strains of B. burgdorferi were involved, by a biopsy culture technique.

METHODS

Skin biopsy specimens were obtained from Ixodes scapularis tick bite sites, processed, and examined for the presence of B. burgdorferi.

RESULTS

B. burgdorferi was cultivated from only 2 of 48 skin biopsy specimens. In both instances duration of tick attachment was approximately 24 hours.

CONCLUSION

In a hyperendemic region for Lyme disease the risk of infection after a deer tick bite appears to be low, particularly if the tick has been attached for less than 24 hours.

Severe dog-bite injuries, introducing the concept of pack attack: a literature review and seven case reports

Attacks on humans by dogs acting as a pack, though uncommon, result in severe, sometimes fatal, injuries. We report seven cases of attacks by packs of dogs (five on children and two on elderly women) including one fatal case. The dangers of dogs acting as a pack are highlighted, particularly when confronted with an unaccompanied child or elderly female. The pattern of injuries and principles of treatment are discussed.

[An unusual case of extensive cadaver ingestion by a domestic dog]

There are only a few reports on cases in which the body of a human who died unnoticed in a house was destructed by a dog. The presented case seems to be unusual in that the extent of destruction was severe and the distribution of injuries was different from that reported in the literature. A 59-year-old man was found dead naked in a room, the cause of death being ischemic heart disease. The lower part of the body was lying in a so-called kotatsu. Wounds were confined to the upper part of the body. The head was skeletonized. The anterior thorax was missing. What was different in our case from previous ones was that the genitals were spared from destruction; the kotatsu frame may have prevented the dog from approaching this region. The extensive destruction within the short period of about 3 days may be explained by the fact that the victim was naked when he died.

[The ultrastructural characteristics of the histopathological changes at the site of attachment to the host body of larvae of the ixodid tick Ixodes ricinus]

The attachment of ixodid tick Ixodes ricinus larvae to white mice and histopathology of host tissue in the attachment site were investigated by means of electronic microscopy. It was demonstrated the presence of cement substance around the mouthparts of tick during the first and the second days of feeding period and the absence of it at the last day of this period. The cement substance consists only of the cement cone (the external cement), situated on the surface of host epidermis. The tick mouthparts in the host dermis were surrounded by zone of modified collagene fibers. Examination of feeding site showed the intensive neutrophil migration and the formation of feeding cavity in 2 days after attachment of tick. At the same time the erythrocytes and active fibroblasts were found in the feeding cavity.

Tick bites in Korea

BACKGROUND

Tick bites are dermatoses not commonly encountered in Korea. Recognizing their clinical signs as well as their histopathologic findings is important in making a diagnosis of tick-related dermatoses. The incidence and causative species are different depending on the geographic areas. The histopathologic findings of tick bites are known to be a variable depending on the species of ticks involved and the duration of their bloodsucking.

METHODS

Five ticks were collected from five patients and three of them were identified as Ixodes (I.) nipponensis.

RESULTS

Histopathologic findings of panniculitis were prominent in four of five cases; septal panniculitis in two cases, and lobular panniculitis in the other cases.

CONCLUSIONS

Ixodes nipponensis was the most common causative species of ticks responsible for tick bites in Korea, and tick bite panniculitis must be considered in the differential diagnosis of panniculitis which is mainly composed of neutrophils.