American Board of Internal Medicine (ABIM) Certification Practice Exam

What factors would lead to the need for hospitalization after a dog bite?

1. Minor swelling and redness

2. Sepsis and infected hand bites

3. Superficial skin irritation

4. Uncomplicated wounds with no signs of infection

The correct answer is: Sepsis and infected hand bites

Hospitalization after a dog bite is particularly warranted in cases where there is a significant risk of sepsis or when the bite has resulted in infected wounds, especially on the hands. Bites can become infected due to the oral flora of the dog, which contains various bacteria that can lead to more severe complications. Hand bites are especially concerning because of the complex anatomy and potential for joint and tendon involvement, which can escalate to serious infections like tendonitis or osteomyelitis. Moreover, patients who show signs of systemic infection, such as fever, increased heart rate, or other systemic symptoms, may require hospitalization for intravenous antibiotics and close monitoring. In cases where infection is present and significant, surgical intervention may also be necessary to manage the wound or to drain any abscesses. In contrast, minor swelling and redness or superficial skin irritation typically do not indicate the need for hospitalization, as these can often be managed in an outpatient setting with monitoring and home care. Uncomplicated wounds with no signs of infection pose a minimal risk and can likewise be treated without hospitalization. Therefore, the presence of sepsis or infected wounds in the context of a dog bite is a critical consideration that justifies hospitalization.