Common Peroneal Nerve Injury Caused by a Wild Boar Attack.

Wild boar-inflicted nerve injuries have been very rarely reported in the literature. A 62-year-old man was attacked by a wild boar in eastern Turkey and brought to the emergency department. He had 5 lacerations on the lower extremities and 2 on the posterior thoracic region. In addition to soft tissue lacerations, he sustained a complete laceration of the left common peroneal nerve with a foot drop. The common peroneal nerve was repaired primarily the day after the attack. The patient was discharged after a short hospital stay without any immediate complications; however, at the 10-mo follow-up, he still had a left foot drop.

Evisceration of intestines with diaphragmatic laceration and gastric perforation secondary to trauma by rhinoceros attack and its management: a case report.

Injuries from animal attack are one of the major public health problems at present scenario globally. Proper documentation is required for the study of different types of injuries caused by animal attacks so that early intervention can be done during life-threatening conditions. Case Presentation: A 36-year-old male presented with an alleged history of attack by two rhinoceros sustaining injuries over the abdomen, chest, shoulder and thigh. Clinical Findings and Investigations: There was a lacerated abdomen with evisceration of the stomach, small intestine, transverse colon and omentum and a lacerated wound over the left lateral thigh and left buttock along with the right shoulder. Extended Focused Assessment with Sonography in Trauma ultrasound showed minimal free fluid in the pelvis. Blood profile revealed reduced haemoglobin and deranged prothrombin time/international normalized ratio. Interventions and Outcome: Patient underwent exploratory laparotomy twice with repair of diaphragmatic injury, excision of avulsed greater omentum in the first setting and repair of gastric perforation in the second setting with stable haemodynamic status. Conclusion: Abdominal evisceration injury by rhinoceros attack is life threatening though rare. Its management should consist of assessing for and controlling associated haemorrhage, assessing for bowel content leakage, covering the eviscerated abdominal contents and early reduction of viscera if there is no active bleeding.

Tibial Plateau Fracture After Attack by an Escaped Goat.

Humans come into contact with goats in wild settings. If a goat feels threatened, it may address the perceived threat violently. While out walking, a 55-y-old man was attacked by an escaped domestic goat. Much as goats interact with each other, this goat pushed him over with its horns and then rose up on 2 legs to come back down on him with its head. The man experienced a Schatzker VI bicondylar tibial plateau fracture that required external and then internal fixation. Besides his physical injuries, he experienced acute stress disorder, which is common after traumatic events. Acute stress reactions can progress into chronic posttraumatic stress disorder but also often resolve. Psychological first aid is appropriate after traumatic events, including animal attacks. It is appropriate to screen for posttraumatic stress disorder symptoms after such events and treat or refer if present. After 1 y, the man returned to full function and experienced no posttraumatic stress disorder.

Perfil dos agravos com animais potencialmente transmissores da raiva, Mato Grosso do Sul, Brasil, 2019 a 2021 / Profile of injury by potential rabies-transmitting animals in Mato Grosso do Sul, Brazil, from 2019 to 2021 / Perfil de enfermedades con animales potencialmente transmisores de rabia en Mato Grosso do Sul, Brasil, de 2019 a 2021

Considerada uma das mais graves doenças tropicais negligenciadas (DTN) do mundo, a raiva promove grande impacto à saúde pública devido a sua evolução letal e ao elevado custo social e econômico. O objetivo desta pesquisa foi descrever o perfil epidemiológico das agressões por animais potencialmente transmissores de raiva, no estado de Mato Grosso do Sul, durante os anos de 2019 a 2021. Foi realizado um estudo epidemiológico retrospectivo, transversal, qualiquantitativo, com dados secundários codificados do Sistema de Informação de Agravos de Notificação: ano e mês, município e zona de ocorrência, idade, sexo, raça, escolaridade, tipo de exposição, região anatômica atingida, características do ferimento, espécie e condição do animal agressor e tratamento preconizado. Foram registradas 24.362 notificações de agressões, com prevalência média de 8,7/1.000 hab. Janeiro apresentou o maior número de notificações. Destacaram-se, entre os agredidos, crianças entre 1 e 9 anos de idade do sexo masculino. A zona de ocorrência de 89,5% dos agravos foi urbana e 81,7% foram provocados por cães. Dentre os indivíduos agredidos, 79,2% receberam tratamento antirrábico pós-exposição com uso de imunobiológico. O estado registrou baixa prevalência de agravos por animais. Notaram-se falhas de preenchimento das fichas de notificação e nos critérios de inclusão de agravos com animais potencialmente transmissores da raiva.

Considered as one of the most serious neglected tropical diseases (NTD) worldwide, rabies greatly impacts public health due to its lethal evolution and high social and economic cost. Given this scenario, this study describes the epidemiological profile of attacks by potential rabies-transmitting animals in the state of Mato Grosso do Sul, Brazil, from 2019 to 2021. A retrospective, cross-sectional, qualitative-quantitative epidemiological study was conducted with secondary data obtained from the Information System for Notifiable Diseases, namely: year and month; municipality and area of occurrence; age; gender; race; education; type of exposure; anatomical region affected; characteristics of the wound; species and condition of the animal; and recommended treatment. A total of 24,362 notifications of animal attacks were reported, with average prevalence of 8.7/1000 inhabitants. January registered the highest number of notifications. Among the victims, male children aged one to nine years stood out. Of the total injuries reported, 89.5% occurred in urban areas and 81.7% were done by dogs. Among the attacked individuals, 79.2% received post-exposure anti-rabies treatment with immunobiological drugs. The state recorded a low prevalence of animal attacks. Results revealed poorly filled out forms and issues with the inclusion criteria used for classifying injuries caused by potential rabies-transmitting animals.

Considerada una de las enfermedades tropicales desatendidas (ETD) más graves del mundo, la rabia tiene un gran impacto en la salud pública debido a su evolución letal y alto costo social y económico. El objetivo de esta investigación es describir el perfil epidemiológico de las agresiones por animales potencialmente transmisores de la rabia, en el estado de Mato Grosso do Sul (Brasil), durante los años de 2019 a 2021. Se realizó un estudio epidemiológico retrospectivo, transversal, cualicualitativo, con datos secundarios codificados del Sistema de Información de Enfermedades de Declaración Obligatoria que contienen: año y mes, municipio y zona de ocurrencia, edad, sexo, raza, nivel de educación, tipo de exposición, región anatómica afectada, características de la herida, especie y condición del animal agresor y tratamiento recomendado. Se registraron 24.362 notificaciones de agresiones, con una prevalencia media de 8,7/1.000 hab. Enero tuvo el mayor número de notificaciones. Entre las víctimas se destacaron niños de entre 1 y 9 años de edad y varones. El área donde ocurrieron el 89,5% de las lesiones fue urbana, y el 81,7% de ellas fueron causadas por perros. Entre los agredidos, el 79,2% recibió tratamiento antirrábico postexposición con uso de inmunobiológicos. El estado registró una baja prevalencia de lesiones causadas por animales. Se observaron fallas en el llenado de los formularios de notificación y en los criterios de inclusión de enfermedades con animales potencialmente transmisores de la rabia.

Human-wildlife conflicts with crocodilians, cetaceans and otters in the tropics and subtropics.

Conservation of freshwater biodiversity and management of human-wildlife conflicts are major conservation challenges globally. Human-wildlife conflict occurs due to attacks on people, depredation of fisheries, damage to fishing equipment and entanglement in nets. Here we review the current literature on conflicts with tropical and subtropical crocodilians, cetaceans and otters in freshwater and brackish habitats. We also present a new multispecies case study of conflicts with four freshwater predators in the Western Amazon: black caiman (Melanosuchus niger), giant otter (Pteronura brasiliensis), boto (Inia geoffrensis) and tucuxi (Sotalia fluviatilis). Documented conflicts occur with 34 crocodilian, cetacean and otter species. Of the species reviewed in this study, 37.5% had conflicts frequently documented in the literature, with the saltwater crocodile (Crocodylus porosus) the most studied species. We found conflict severity had a positive relationship with species body mass, and a negative relationship with IUCN Red List status. In the Amazonian case study, we found that the black caiman was ranked as the greatest 'problem' followed by the boto, giant otter and tucuxi. There was a significant difference between the responses of local fishers when each of the four species were found entangled in nets. We make recommendations for future research, based on the findings of the review and Amazon case study, including the need to standardise data collection.

Patterns and Management of Unprovoked Bull Attack Injuries: A Retrospective Case Series.

Introduction Animal attacks cause a considerable number of injuries and lead to morbidity and mortality among children and adults. Bull gore injuries following bullfighting and other provoked attacks have been frequently described in literature. Our study describes the pattern of injuries and the unique mechanisms and management of blunt and penetrating trauma associated with unprovoked bull attacks. Methods In this retrospective study, we collected the data of 36 patients presenting to our emergency department with a history of bullhorn injury. The data comprised age, sex, location of injury, type and description of the injury, surgical procedure performed if any, requirement of postoperative intensive care unit (ICU) admission, and mortality. The data were then compiled and analyzed with MS Excel. Results Among the 36 patients, blunt injuries constituted 58.3% of cases, whereas penetrating injuries were seen in 41.7%. Men were commonly injured with a mean age of 39.1 years. Thorax (36%) and abdomen (33%) were the common sites of injury followed by perineum (17%), head (5%), spine (6%), and extremity (2%). Fall following the impact of bull led to indirect injuries, such as intracranial hemorrhage, parietal bone fracture, cervical spine injuries, and tibial fracture. More than half of the patients (n=19, 52.8%) required some form of surgery under local or general anesthesia. Among the operated patients, seven required postoperative ICU care and two expired. Conclusion Animal attack injuries represent a less explored niche of surgical conditions. Management in the emergency department includes prompt resuscitation to achieve hemodynamic stability, thorough wound wash to remove the contaminants, and appropriate imaging, if indicated. Wound exploration is recommended for penetrating injuries and on a case-to-case basis for blunt injuries. The complications of these wounds are due to multiple wound paths, muscle tearing, evisceration of internal organs, and high risk of wound infection.

Traumatic lung herniation due to Cow's kick.

Lung herniation, where the lung and its visceral and parietal components protrude outwards from a defect in the chest wall, is not common. It is most commonly secondary to blunt or penetrating trauma. The diagnosis is difficult, as the presentation differs according to aetiology. Ultrasound or CT scanning help in diagnosis and treatment planning. We present a 70-year-old female patient with lung herniation following a cow's kick on the thorax.

Fatal captive tiger attack - A case report with review of literature.

The attacks on humans by big captive felids has been an issue of concern for the administration of zoological parks and wildlife conservationists. The theme of human-animal conflict takes a new dimension for the wild animals kept in zoos, circuses, exotic animal farms, and private custody. Despite the potential dangers involved, the zookeepers have to closely interact with the captive tigers for catering to the needs of food, general health, and wellbeing. The literature has described cases of attacks by captive tigers resulting in the death of the primary caretaker. The injuries present on such bodies include multiple punctured lacerations, traumatic amputations, damage to the vital organs of the neck, fracture-dislocation of cervical vertebrae, and abrasions secondary to the dragging of the body. We present a rare fatal case of an attack of a tiger on keeper during the night hours while he entered the cage to look after the tiger who was suffering from gastroenteritis for a few days and was not taking his feed aptly. The keeper had a twelve-year long relation with the tiger, and the discovery of his death was an astonishment for zoo administration. This case describes the autopsy findings emphasizing the distribution of injuries, along with inquiring into the scene of the incident. The details about the predatory behaviour of tigers and stereotypic behaviours in captivity have been discussed.

Occupational Fatalities Due to Mammal-Related Accidents in Japan, 2000-2019.

INTRODUCTION: Animal-related fatal accidents occur annually while individuals are outside working. This study intended to evaluate the trends of occupational fatal accidents related to mammals and compare them with nonoccupational accidents. METHODS: We collected occupational and nonoccupational fatalities related to mammals between 2000 and 2019 from data on fatal occupational accident cases certified by the Ministry of Health, Labor and Welfare, Japan, in addition to other statistics from relevant ministries, media reports such as newspapers, and academic case reports. RESULTS: A total of 109 fatal accidents related to mammals were confirmed as occurring during work, and 129 were confirmed as taking place outside of work. Of the former, accidents among livestock farmers and horse racing-related workers accounted for about half. Among the accidents not related to work, dog attacks, infectious diseases from cats or dogs, traffic accidents with wild animals, and bear attacks during wild vegetable picking were common. Deaths from infectious diseases caused by dogs and cats have rarely been reported in the mass media. CONCLUSIONS: Although the number of fatal occupational accidents related to mammals is not large, we concluded that it is necessary to continue preventive measures centered on accidents at livestock farms and in horse racing-related workplaces. It is also necessary to inform people about the risks of infectious diseases mediated by dogs and cats.

Injuries and deaths caused by non-human primate attacks: Paediatric vulnerability.

A six-month-old girl was taken from her mother's lap by a macaque monkey (Macaca) that had entered the room through an open door. The monkey escaped with the infant but subsequently dropped her from a rooftop terrace. Death occurred soon after impact with the ground, and was found at autopsy to be due to blunt cranio-cerebral trauma with skull fractures and intracranial haemorrhage. Monkeys and apes may cause a variety of serious and potentially life-threatening injuries and may manifest quite unpredictable and aggressive behaviour around humans. The very young are particularly vulnerable to primate attacks, and 'baby theft' by apes and monkeys is an event that has now been reported, albeit rarely, in a number of different countries around the world. The fatally injured infants have died from bites, falls and drowning. Chimpanzees in the wild may also specifically hunt human infants for food.

Fatal donkey bite in children: a case report.

Although animal-inflicted injuries are a worldwide major public health problem, lethal donkey bites have very rarely been reported. We describe the case of a 21-month-old girl that was found dead in a farmyard next to a donkey that belonged to the family. Examination of the body showed bite marks on the right side of the neck and the upper part of the shoulder. Death was attributed to cervical trauma and spine injuries from a donkey attack.

Polytrauma from a North American Black Bear Attack.

Bear attacks, although rare, can inflict life-threatening injuries. We present the case of a 50-y-old woman from rural Pennsylvania who was attacked by a North American black bear, Ursus americanus. She sustained multiple complex injuries including near-complete scalp avulsion, bilateral ear avulsions, and fractures of the face, ribs, and pelvis. These injuries are similar to those sustained in other bear maulings reported in the literature and required both acute intervention and a multidisciplinary approach to recovery.

Bull horn injury causing traumatic tooth intrusion - ultrasound and CT imaging.

INTRODUCTION: Traumatic injury to upper alveolus may result in apical displacement of the affected tooth/teeth into the underlying alveolar bone. The tooth while being driven into the socket under the upwardly directed impact force usually causes a crushing fracture of the alveolar socket bone. The tooth may also be displaced through the labial plate of bone or may even impinge upon the bud of the permanent tooth. CASE REPORT: We present a case of tooth intrusion due to bull horn injury and its imaging features on ultrasound and CT scan. DISCUSSION: Most common teeth involved in dental trauma in children of 6 to 12 year age group, are the maxillary anteriors, and this age group also constitutes the most common group in whom tooth intrusion is seen. Tooth intrusion usually involves a single dental element. Common etiologic causes are injuries, falls, sports accidents, violence and traffic accidents. Traumatic intrusion due to injury by animals is rarely described and is more commonly seen in less developed areas that too in rural set-up where man-animal encounters are frequent. CONCLUSION: In such cases, whenever the conventional imaging modalities like the X-rays such as intra oral peri-apical views and orthopantomograms are unavailable, or where use of ionizing radiation is a grave concern (especially in children and pregnant patients), ultrasonography offers a non-invasive diagnostic imaging method which helps in diagnosis of the condition and also helps in supplementing the clinical information, thereby helping in better understanding of the underlying condition.

Complex Wound Closure Following Mysterious and Vicious Animal Attack.

Animal attacks are a worrisome and dangerous entity that occur at high volumes and are evaluated frequently by ER physicians, primary care physicians, trauma teams, acute care surgeons, and plastic surgeons. The severity of animal attacks can range from a small insect sting to mauling by large animal, and even death. With animal attacks of high intensity, there is often significant scratching, tearing, shearing, with destruction of the skin, subcutaneous tissues, muscles, and bone. Serious attacks frequently lead to infection, sepsis, pain, loss of sensation or mobility, operative interventions, and amputations of affected limbs. We report herein the traumatic mauling of a woman by a reported unknown animal. Though the entity of animal attacks has been reported in the past, this case dictates presentation given the suspicious circumstances surrounding the attack, the involvement of her care requiring a multidisciplinary surgical approach via trauma surgery and plastic surgery, multiple extensive interventions, and the excellent take of the split thickness skin graft (STSG) after the use of a dermal regeneration template (DRT).

Fatal rooster attack.

A 76-year-old woman was attacked by a domestic rooster on her rural property while collecting eggs. The bird pecked her lower left leg causing significant hemorrhage with collapse and death. The decedent's past medical history included treated hypertension, hyperlipidemia, non-insulin dependent diabetes mellitus and varicose veins. At autopsy the major findings were limited to the lower left leg which was covered with adherent dried blood. Two small bleeding lacerations were present, one of which was located immediately over a perforated large varix. Death was therefore due to exsanguination from bleeding varicose veins following an attack by a rooster. This case demonstrates that even relatively small domestic animals may be able to inflict lethal injuries in individuals if there are specific vascular vulnerabilities present.

The "T's" of snakebite injury in the USA: fact or fiction?

BACKGROUND: Venomous snakebites can result in serious morbidity and mortality. In the USA, the "T's of snakebites" (testosterone, teasing, touching, trucks, tattoos & toothless (poverTy), Texas, tequila, teenagers, and tanks) originate from anecdotes used to colloquially highlight venomous snakebite risk factors. We performed an epidemiologic assessment of venomous snakebites in the USA with the objective of evaluating the validity of the "T's of snakebites" at a national level. METHODS: We performed a retrospective analysis of the National Emergency Department Sample. Data from January 1, 2016 to December 31, 2016 were obtained. All emergency department (ED) encounters corresponding to a venomous snakebite injury were identified using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. Primary outcomes were mortality and inpatient admission. Demographic, injury, and hospital characteristics were assessed. Data were analyzed according to survey methodology. Weighted values are reported. RESULTS: In 2016, 11 138 patients presented to an ED with a venomous snakebite. There were 4173 (37%) persons aged 18 to 44, and 7213 (65%) were male. Most snakebites were reported from the South (n=9079; 82%), although snakebites were reported from every region in the USA. Only 3792 (34%) snakebites occurred in rural counties. Persons in the lowest income quartile by zip code were the most heavily represented (n=4337; 39%). The most common site of injury was the distal upper extremity (n=4884; 44%). Multivariate analysis revealed that species of snake (OR=0.81; 95% CI 0.73 to 0.88) and older age (OR=1.42; 95% CI 1.08 to 1.87) were associated with hospital admission. There were <10 inpatient deaths identified, and no variables were predictive of death. DISCUSSION: Some of the "T's of snakebites" may be valid colloquial predictors of the risk for venomous snakebites. Based on national data, common demographics of venomous snakebite victims include lower income, Caucasian, and adult men in the South who are bit on the upper extremity. Understanding common demographics of venomous snakebite victims can effectuate targeted public health prevention messaging. LEVEL OF EVIDENCE: IV.

Fatal attack on a pedestrian by an escaped circus elephant.

We report the case of a 65-year-old man who was attacked and killed by a female elephant that had previously escaped from a nearby circus. According to a witness the man was lifted up by the tusks, flung into the air and stomped upon. At autopsy the body showed signs of severe blunt force trauma and impalement, including multiple lacerations of the skin, a crushed thorax, a spinal fracture and a fractured humerus. The spinal cord and the major abdominal vessels were severed. There have been very few elephant attacks in Europe; this is the first reported case in Germany.

Environmental Deaths in the Northern Territory of Australia, 2003-2018.

INTRODUCTION: The Northern Territory is sparsely populated with a distinctive climate, geography, and wildlife compared with other states and territories in Australia. Environmental deaths (including drowning, heat-related deaths or environmental exposure, fatal animal attacks or envenomation, and lightning deaths) are reportable to the Northern Territory coroner for further investigation. METHODS: Databases of the Northern Territory coroner's office and the Royal Darwin Hospital Forensic Pathology Unit were searched to identify all environmental deaths over a 15-y period (July 1, 2003-June 30, 2018). RESULTS: A total of 4535 cases were reported to the Northern Territory coroner's office during the studied period, of which 167 (4%) were environmental deaths. Drowning was the most common type of environmental death, followed by heat-related deaths and fatal crocodile attacks. Deaths resulting from lightning and animals other than crocodiles are rare. Local resident, male victims in rural locations were the most commonly affected. Alcohol intoxication played a role in about one-third of cases, and in approximately one-third of cases a known underlying medical condition was identified. CONCLUSIONS: The Northern Territory has a challenging environment that is hot, humid, remote, and isolated. Circumstantial information and thorough police investigations are essential in the medicolegal investigation of environmental deaths.

The Forensic Pathology of Fatal Attacks by the Large Mammals Inhabiting the Nordic Wilderness-A Literature Review.

Fatalities due to animal attacks are rare in forensic medical work but have been known to pose problems due to their potential to mimic homicide. This review summarizes reported cases of fatal attacks by large mammals that inhabit the Nordic wilderness, namely brown bear, moose, wild boar, and wolf, and attempts to elucidate injury patterns that can guide the forensic pathologist to identifying the species and modus operandi of the attacker. A tendency toward a species-specific injury pattern was observed. Injuries by bear and especially wolf are dominated by biting whereas moose and wild boar do not seem to bite their victims. The bear uses its paws, both for hitting, resulting in crush injury and fractures, and clawing with resulting excoriations and possible penetrating injuries. Crush injuries and fractures appear, on the other hand, to be minimal or absent in attacks by wolf and wild boar.