2a). In time, however, our protocol may change as drug resistance patterns change. When swelling of a palm-thorn puncture wound occurs, arthrocentesis may be necessary to rule out bacterial or fungal infection. Some puncture wounds are on the surface; however, others can be very deep. I seached for information about this type of tree and found nothing to suggest its thorns are poisonous. Butt TS, Khan A, Ahmad MA, et al. One should start with a comprehensive medical history, including the patient’s current medications and allergies. Then dress the wound and be sure to keep the area clean. Saha P, Parrish CA, McMillan. If the patient requires hospital admission and an intravenous line, one can give broad-spectrum antibiotics such as piperacillin/tazobactam (Zosyn, Pfizer) or imipenem/cilastatin (Primaxin, Merck). See Sweaty Tennis Shoe Syndrome (infection with pseudomonas aeruginosa); Other common sites: Knees, Arms and hands Puncture causes. 1989;150(5):545-547. Antibiotic therapy is indicated for a puncture wound when the wound is infected or if medical help is sought more than 24 hours after the injury. 1999;20(1):21-23. 1999;16(4):583-596. Sporotrichosis usually affects the skin or tissues underneath the skin. The most commonly used antibiotics include cephalosporins such as cephalexin, penicillin-type drugs including amoxicillin-clavulanic acid or dicloxacillin, and erythromycin, a macrolide antibiotic. Clin Podiatr Med Surg. After entering the body, the fungal spores grow and replicate to spread quickly into the body tissues. 9. Not only are such wounds relatively avascular, they have a greater potential for inoculation and infection. They found that patients with puncture wounds in zone 1 had the highest risk of osteomyelitis development followed by those with zone 3 puncture wounds. 2. If not then you need to get vaccinated and treated. Both times, the thorn left a small 'husk' in the puncture wound, which I removed immediately. Zone 3 includes the plantar aspect of the calcaneus. J Pediatr. Oral antibiotics are effective in treating uncomplicated wound infections as well as preventing serious infectious outcomes. Patients who present early (less than six hours) with a clean, non-infected puncture wound with no medical comorbidities should receive clinical treatment. Bottom of foot (plantar) affected in 50% of cases. 14. While plant thorn arthritis is technically noninfectious, these two forms of infectious arthritis can occur from plant thorn puncture of a joint, with or without true plant thorn arthritis. Addressing Puncture Wounds In Patients With Diabetes, When a patient with diabetes presents with a puncture wound, one must consider a unique set of factors. 15. In this setting, empiric antibiotics are not required. Houston A, Roy W, Faust R. Tetanus prophylaxis in the treatment of puncture wounds of patients in the deep South. First aid treatment for a puncture wound includes: Cleaning the wound thoroughly. The first symptom of cutaneous (skin) sporotrichosisis usually a small, painless bump that can develop any time from 1 to 12 weeks after exposure to the fungus. In those cases, advanced imaging studies may be necessary. I am getting ready to see an orthopedic surgeon. Hospitalization and intravenous antibiotics are required for extensive soft tissue infections from a puncture wound. Fisher MC, Goldsmith JF, Gilligan PH. 1985;106:607-609. The way you treat this type of injury is by pouring hydrogen peroxide on the wound to be sure that any bacteria is killed. Radionuclide imaging is important and very helpful when one suspects osteomyelitis. Pasteurella multocida has been isolated from dog and cat bites as well as Eikenella corrodens in human bite wounds.14 Miscellaneous organisms that researchers have isolated from puncture wounds occurring in brackish water include Aeromonas hydrophila and Mycobacterium marinum.15. Whether the paw injury is a tiny puncture from a thorn or a sore from walking on a hot surface, thereâs always an opportunity for an infection to take hold no matter the size of the injury. Infections associated with puncture wounds that occur in specialized settings such as with animal or human bites and water exposure are discussed in further detail elsewhere. Bougainvillea thorn puncture treatment Download Here Free HealthCareMagic App to Ask a Doctor All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. Researchers have shown tetanus to be three times more common and associated fatalities are four times more prevalent in this patient population.19 Armstrong and colleagues reviewed the course of patients with diabetes who suffered puncture wounds and found them 46 times more likely to have an amputation than those without diabetes.20. You may be given antibiotics and a tetanus shot. Broad-spectrum antibiotics are also a good idea for the patient with diabetes or for a dirty wound. Itâs likely your doctor will prescribe a several-month course of antifungal medication, such as itraconazole. Dr. Thun is a third-year podiatric surgical resident at Health Alliance of the Hudson Valley. If time has elapsed, the wound may have closed over and it can be difficult to locate the area of penetration. It is now more than two months later, and while I â¦ Prophylactic antibiotic use may reduce the incidence of infection in human bite wounds. The incidence of osteomyelitis is associated with the location of the injury, delay in treatment and whether patients were wearing footwear at the time of injury.6, Various authors have reported the occurrence of osteomyelitis in puncture wounds but with differences in the incidence rate. Human Bite, Dog Bite, Cat Bite) Delayed presentation (>18 hours) Transmission can occur when people walking barefoot step on a thorn. 2006;355(7):666-673. 1. 1992;10(4):801-821. First-generation cephalosporins such as cephalexin (Keflex, Aspen Pharmacare) or cefadroxil (Duricef) are sufficient for most superficial puncture wounds. Empiric therapy should include parenteral penicillin plus either an antistaphylococcal penicillin or a first-generation cephalosporin. At this point, one should consider a diagnosis of osteomyelitis and/or a retained foreign body. The infection is more common among gardeners, nursery workers, and farmers who work with roses, moss, hay, and soil. 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