title: Above-elbow amputation and death following human bite mismanaged by quacks: a case report and review of literature.
abstract: BACKGROUND
  Human bite is a common injury sustained during a fight, love passion, self mutilation, cannibalism or vampirism. Although widely reported as being more dangerous than animal bites, such complications as limb amputation from gangrene and eventually death is either uncommon or scarcely reported in our environment.
  
  
  OBJECTIVE
  To highlight the dangers of human bite as a potential cause of severe morbidity and mortality especially when poorly managed.
  
  
  METHODS
  A 30 year old Fulani herdsman with gangrene of the right hand, and distal forearm presenting in coma 10 days after sustaining human bite is presented and relevant related literature reviewed.
  
  
  METHODS
  M.U. is a 30 year old Fulani herdsman who presented to us at the accident and emergency unit with 10 days history of human bite to the first web space of the right hand, 5 days history of gangrenous hand and distal foreman, and 2 days history of loss of consciousness. The injury was inflicted by a fellow herdsman during a fight. He then commenced treatment with a patent medicine dealer. A few days later the hand became swollen with associated severe pains, serous discharge and subsequent darkish discoloration, frank pus exudates and loss of hand function. Two days prior to presentation, he lapsed into unconsciousness after complaining of severe weakness and fever. Following his presentation, clinical examination and investigation, he was offered a below elbow guillotine amputation. However by the next day, he deteriorated with GCS of 5/15 and subsequently died after 24 hours of presentation.
  
  
  CONCLUSIONS
  Human bite can be a cause of severe morbidity and mortality. Treatment by quacks should be discouraged while early presentation, surgical debridement and delayed wound closure should be emphasized along with other surgical principles.
authors: Department of Orthopaedics and Traumatology, National Orthopaedic Hospital, Enugu, Nigeria. toezigbo@yahoo.com
authors: E C
authors: EC
authors: Iyidobi
authors: A U
authors: AU
authors: Nwokocha
authors: C U
authors: CU
authors: Nwadinigwe
authors: K I
authors: KI
authors: Ugwoke
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D001734:Bites, Human / Q000150:complications* / Q000628:therapy; D003128:Coma / Q000209:etiology; D017809:Fatal Outcome; D005542:Forearm / Q000473:pathology* / Q000601:surgery; D005734:Gangrene / Q000209:etiology* / Q000601:surgery; D006230:Hand Injuries / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D011781:Quackery; D012772:Shock, Septic / Q000209:etiology*