unknown bite

9 years old previously healthy child had a history of unknown bite having bite mark present in right little finger and bluish discolouration of saliva noted by parents next day morning...kindly explore diagnosis and Management ...

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i m not sure . may b acquired methhemoglobinemia . spider bites can cause it . cbc crp bt ct . methhemoglobin level . spo2 level will b normal in such cases . treatment is high dose vit c methylene blue .

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If child is normally wake up and no letharginess,check for urine discoloration. Keep strict watch Inj tt Inj Dexona Inj Avil.

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From the history one can assume that the bite had occurred in the night and the parents noticed that in the morning and the child is alive. Put a bandage over the right wrist should be loose enough not to occlued the lymph flow. Take blood samples for CBC, BT,CT ,RBS UREA CREATININE and do urine routine and Ecg also. Rule out envenomation. Bluish saliva could be saliva in the background of cyanosed tongue. In that case child might be very sick. Do check pulse BP . Throughly wash the wound with saline and antiseptic solution. Apply antibiotic creams. Leave the wound open. Give tetanus toxoid injection. Then continue your treatment according to the lab. Results.

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Bites should be taken seriously. May be managed as Snake bite. Do Coagulation test in 10ml blood .

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Kindly upload the pics

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PROPHYLAXIS TETANUS VACCINE RABIES VACCINE CBC? ESR ?

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Go for BT,CT,WBCT and renal parameters

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May be rat bite..Put one TT.inj.felliwed by.inj.dexomethozone.injection Fellowd by.levo.citrazine syrup.for 5 days at night after food.

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