Though there are scarce reports of vervet monkey patterns of attack documented in the literature, it has been shown that other primates such as chimpanzees attack more frequently based on scarcity of native food related to changing weather patterns [16, 17]. Aside from causing internal organ injury and soft tissue damage, animal attacks

also may transmit Daporinad mw infectious diseases. Vervet monkeys have been shown to carry multiple parasitic and bacterial diseases, as well as viruses transmissible to humans [18]. These include Rabies, Ebola Reston, Herpes B Virus, Monkeypox, Yellow Fever, Simian Immunodeficiency Virus, and tuberculosis [19]. Rabies is the most commonly acknowledged disease transmitted from cats or dogs to humans, and this extends to hyenas [8]. Crocodile mouths may harbor Aeromonas hydrophilia, Pseudomonas aeruginosa, Proteus, and Salmonella [20]. Principles of managing these attacks in the resource limited setting include using a systematic survey to rule out major traumatic injury; once these injuries have been addressed, then focus turns to soft tissue and prevention of local and/or systemic

infection. This is achieved MK-1775 supplier through careful cleaning with soap and water and an anti-infective such as betadine. Tetanus and rabies vaccines also should be administered to patients who suffered unprovoked attack from any wild animal. Prophylactic antibiotics are used in our setting, though they remain controversial in general. One study has proven that post-bite infection may be reduced to < 2.0% in ACP-196 mw domestic cat and dog bites when prophylactic antibiotics are used, and suggests that antibiotics may be prudent in wild animal attacks [21]. Further argument for prophylactic antibiotics in our setting include the following: the rural location of many attacks, poor transport systems, and subsequent late presentation of injuries; puncture-type wounds; and, high rate of immunodeficiency in the East African population [22]. Regarding the surgical management

of these wounds, it is most ideal to attempt primary closure of facial injuries for cosmetic purposes. However, in the clinical setting of immunodeficiency or Selleckchem 5FU high risk for infection in a cat, dog, monkey, or livestock wound, we emphasize that delayed primary closure represents the most appropriate surgical management [23]. Conclusion With trauma triage of animal attacks; vaccination against viruses and antibiotic prophylaxis against common animal-borne organisms in the initial period after attack; and, appropriate surgical management, wild animal injuries can be managed effectively in a resource-limited setting. Given the increasing human-wild animal encounters in changing ecosystems and increasing population in East Africa, rural and tertiary care providers should be familiar with the triage and treatment of varying animal attacks, and when these require referral or can be managed remotely.