title: Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report.
abstract: BACKGROUND
  A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury.
  
  
  METHODS
  A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder.
  
  
  CONCLUSIONS
  There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk.
authors: Department of Pediatric Surgery, University General Hospital of Heraklion, Crete, Greece.
authors: Dimitrios
authors: D
authors: Anyfantakis
authors: Emmanouil
authors: E
authors: Botzakis
authors: Evangelos
authors: E
authors: Mplevrakis
authors: Emmanouil K
authors: EK
authors: Symvoulakis
authors: Ioannis
authors: I
authors: Arbiros