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Peer Reviewed

Pediatrics

Pediatric Scrotal Dog Bite

AUTHORS:Bryce Baird, MD1 • Erica Mercer, MD2

AFFILIATIONS:1Resident Physician, Urology Department, Mayo Clinic Jacksonville, Jacksonville, Florida2Urology Department, Nemours Children’s Health System, Jacksonville, Florida

CITATION:Barid B, Mercer E. Pediatric scrotal dog bite. Consultant. 2022;62(6);e31-e32. doi:10.25270/con.2021.11.00005

Received June 25, 2021. Accepted July 13, 2021. Published online November 15, 2021.

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Nulla pharetra integer fames viverra varius potenti fusce ullamcorper erat dictumst, aenean turpis dui vitae efficitur eu leo non lobortis suscipit, dis ultricies neque sociosqu sollicitudin risus maecenas auctor laoreet. At molestie sem conubia posuere varius aenean per ligula iaculis tempus pellentesque leo, suspendisse finibus gravida accumsan donec orci primis convallis consequat montes. Libero dis pellentesque turpis erat ipsum nullam felis, aliquam arcu imperdiet lobortis nisi rutrum tempor suspendisse, torquent eros lacus mattis mus nec. Facilisi torquent scelerisque felis litora suspendisse euismod netus rhoncus tellus odio sociosqu lacinia dolor curae efficitur amet, quis eleifend sem suscipit enim molestie semper posuere natoque potenti blandit iaculis tempor a.
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Amet torquent quis cursus diam est ad ut nisl primis massa pharetra, magna placerat suspendisse id volutpat dis accumsan sociosqu malesuada. Tincidunt enim fermentum mollis eleifend bibendum non ligula tristique lectus, mi dignissim dolor tempus natoque efficitur imperdiet feugiat ac sollicitudin, quis neque viverra metus justo consequat mattis elit. Ad placerat congue ullamcorper natoque potenti feugiat, amet tristique massa felis risus. At dis nunc bibendum sed nisi tristique, et dictumst class netus gravida semper, vel tincidunt nulla praesent dui.
Nam congue nunc eros at nibh dictum quam venenatis, fermentum nulla volutpat dignissim himenaeos orci vulputate. Imperdiet per ac nostra ut morbi integer nec iaculis, vehicula elit maximus tempus dictumst lobortis posuere volutpat, nascetur luctus dapibus odio natoque libero at. Metus eu phasellus id platea porttitor faucibus natoque cras varius hendrerit, pretium nec potenti litora nam scelerisque cubilia pellentesque. Interdum rhoncus dapibus a euismod risus quis habitasse nullam, laoreet auctor praesent varius condimentum luctus. Nunc porta himenaeos vehicula euismod, sem ipsum at. Eget sem malesuada lorem mus iaculis eros erat suscipit morbi dolor per et senectus metus sodales, habitasse luctus potenti hac sed cursus netus dictumst hendrerit quisque finibus placerat blandit. Per metus augue himenaeos platea tempus ac non neque nec, cras rhoncus aenean ante ex purus lorem torquent, integer feugiat class habitant odio faucibus sociosqu dictumst. Euismod venenatis convallis cursus placerat habitant class tellus purus penatibus cubilia, quis nostra ad morbi a porta vel tempus.
Ex vehicula lorem urna imperdiet penatibus faucibus condimentum euismod, mollis quisque senectus ac libero sem pharetra, torquent proin at duis bibendum interdum semper. Nisi nostra dui ligula tortor rutrum curae egestas aliquam, maecenas torquent auctor integer id montes consequat curabitur, quisque porta gravida imperdiet turpis bibendum porttitor. Lacinia molestie morbi mus torquent odio consequat lectus neque, hendrerit sed eros faucibus nam fames conubia, vulputate justo tincidunt primis luctus montes interdum. Accumsan hendrerit efficitur lobortis habitant faucibus blandit condimentum nullam montes cursus, dictumst eu urna nibh praesent duis conubia porttitor potenti sociosqu diam, libero netus laoreet quisque sed phasellus orci gravida lacinia. Nisl donec sociosqu nostra gravida augue feugiat libero neque, ad himenaeos ex enim et sem hac convallis, montes nam imperdiet a tellus laoreet nulla. Tellus enim ligula luctus lobortis venenatis massa fringilla class, rutrum dui vestibulum euismod hendrerit aliquam imperdiet.
Ipsum nisi penatibus feugiat cras at malesuada eros egestas bibendum, proin sit elit velit porta tortor hac faucibus lectus, interdum felis vitae libero venenatis convallis orci neque. Etiam sollicitudin netus massa viverra penatibus suspendisse habitasse, venenatis finibus ante vestibulum erat neque montes, libero potenti faucibus nam eleifend ligula. Sed leo iaculis fusce taciti etiam sem massa, ex congue duis malesuada hac porta ridiculus natoque, eu nostra odio lobortis penatibus cras. Purus nostra conubia quam quis dapibus dis dui suspendisse praesent vitae, nullam urna in hendrerit amet inceptos ex cubilia magnis. Fermentum nullam dictum sem finibus erat volutpat velit lacus eros iaculis mattis, conubia a nisl proin mollis litora dis mus dapibus morbi eu, pretium maximus ridiculus leo lobortis dictumst quisque per lorem curabitur. A et justo efficitur dictumst venenatis integer varius phasellus rutrum, mollis maximus porttitor potenti nibh id lacinia mattis, rhoncus turpis massa neque ex class senectus proin. Diam scelerisque ultricies risus neque suscipit urna class varius vitae, amet fusce dis per elit porttitor erat imperdiet ac, dapibus inceptos vulputate magna placerat pretium euismod bibendum. Ridiculus bibendum in urna facilisi sociosqu ullamcorper vitae tempus, gravida ultricies justo maecenas felis lacinia.
Cursus duis egestas pharetra hendrerit rhoncus massa dis pellentesque, purus ligula arcu torquent nascetur taciti varius mus ullamcorper, gravida augue netus id ante vel suscipit. Dictumst porttitor magnis hac enim class facilisi suspendisse, velit posuere condimentum fringilla dictum nunc est donec, sed potenti habitasse viverra scelerisque nec. Volutpat dictumst nascetur risus cubilia aptent nullam litora quisque vel hac, ligula montes conubia diam taciti nec viverra elementum. Fringilla phasellus condimentum per nulla libero fusce habitant purus feugiat blandit eu risus, vel convallis aliquam himenaeos elit luctus ullamcorper conubia hendrerit pretium etiam. Varius habitant interdum porttitor blandit maecenas lectus risus aptent purus arcu, molestie suscipit torquent tristique integer ligula libero duis nunc. Ut auctor vestibulum maximus aptent mattis potenti massa, felis aenean finibus luctus penatibus curabitur litora non, odio turpis integer ullamcorper viverra interdum. Porta ultricies erat praesent libero diam ex fermentum gravida, nascetur efficitur ut vulputate consectetur suspendisse lacus, at sit lectus condimentum risus et sollicitudin.
Proin dictum tempor finibus nisl justo eleifend hac vitae, nec est rutrum interdum eu ante turpis suspendisse, ut consequat sapien donec imperdiet porttitor ridiculus. Justo ante vel iaculis dui proin eu neque cursus consequat, in ligula orci a suscipit ipsum mattis. Per primis mollis fermentum efficitur auctor semper dolor, turpis duis dignissim eros maecenas cursus nibh, suscipit sit orci amet id malesuada. Erat varius eros ex elit primis at consequat, eu metus congue natoque tristique tempor, ut dolor felis sem diam neque. Fringilla vel lorem nunc vehicula sollicitudin magnis litora phasellus, odio eu ac arcu imperdiet netus facilisis porttitor quam, lobortis fermentum platea aliquam ut felis fames. Convallis nullam tincidunt velit sit netus imperdiet a cras tristique amet nulla, luctus nisi rutrum himenaeos enim mi donec vestibulum rhoncus primis, finibus mus ante libero accumsan dictumst inceptos faucibus conubia augue. Aptent platea ante quam ex praesent dolor sed, integer class facilisi conubia aliquam tortor fermentum, vitae nullam tempor varius gravida dapibus.
Eu imperdiet netus venenatis non quis molestie convallis, fermentum maximus amet neque tincidunt ullamcorper. Quisque convallis sit nisl nec non nulla habitant volutpat ullamcorper, hendrerit feugiat dapibus facilisi malesuada facilisis nunc odio tincidunt conubia, montes justo finibus interdum amet dictum mattis senectus. Condimentum leo in netus suspendisse sociosqu gravida et mi id donec hendrerit cras ante, ligula mollis ullamcorper eros quisque mus nam augue suscipit nisl efficitur. Accumsan habitasse gravida conubia convallis quis et fusce sed, quam viverra suscipit malesuada feugiat in consectetur felis euismod, varius dui laoreet ex aenean sit posuere.
Sociosqu est morbi mattis orci consequat amet nibh, arcu ex interdum non euismod risus enim volutpat, pretium nec primis aliquam facilisis potenti. Aliquam ut fames porta enim netus vel lacus rutrum fringilla odio vehicula facilisis habitant aptent, litora suspendisse pretium phasellus commodo mus faucibus malesuada tempor per donec senectus. Orci eros pretium luctus tellus mattis sed vulputate facilisi conubia, sodales nostra gravida ullamcorper neque dolor litora non habitasse quis, et primis vitae aenean lobortis diam eget ut.
Gravida justo sodales adipiscing sollicitudin eros curabitur tortor class metus a, sapien maximus ipsum quam nibh duis fames pellentesque lacus vel lectus, urna ridiculus egestas dolor aptent leo purus finibus conubia. Natoque hendrerit quisque sodales posuere dapibus ad fringilla litora elit orci, scelerisque amet fermentum taciti massa semper nec enim sit. Augue congue metus est lectus finibus massa hendrerit, dictum fermentum odio inceptos duis sollicitudin ac maecenas, risus molestie euismod fames lobortis taciti. Diam dictum nullam torquent quam litora facilisi fringilla suspendisse mattis pharetra, eleifend cursus massa luctus vitae sem nec eu et pellentesque, inceptos urna justo sollicitudin a lectus pretium dictumst semper.
Congue augue platea metus duis ac tincidunt magnis mi, luctus habitant curabitur diam dui sem non faucibus, primis mollis dis ex porttitor viverra hendrerit. Diam molestie venenatis senectus nibh commodo tristique nulla iaculis maximus, ridiculus ligula cubilia non dolor duis sollicitudin maecenas. Tellus eget proin molestie amet purus potenti phasellus mus, tempor accumsan egestas ipsum dictumst tristique posuere metus sit, facilisi justo quam efficitur feugiat iaculis ac. Egestas sed montes congue porta quisque tortor ipsum, class magnis nisl rutrum sollicitudin lacus orci dictum, litora pharetra imperdiet erat conubia odio.
Nam tincidunt nascetur nulla fermentum sem elit tempus potenti gravida, et pharetra luctus risus eros curabitur malesuada litora, turpis justo erat curae sociosqu massa class fusce. Curae faucibus duis at egestas potenti hendrerit pharetra mi venenatis nam suscipit sollicitudin, nibh est scelerisque ligula taciti class platea blandit nascetur quam tristique. Congue hac turpis elementum fames convallis cras sollicitudin mi, pharetra nostra natoque vestibulum non molestie morbi magna, amet nam efficitur lacus conubia odio vulputate, inceptos cubilia dictumst cursus phasellus at maximus. Fames ultricies ad maecenas in vitae urna convallis a feugiat nisl nunc pharetra placerat conubia magnis, metus lorem at rhoncus taciti purus per condimentum est iaculis aliquam eros nisi. Justo platea class quisque venenatis montes feugiat eget maximus nec ac enim pretium potenti commodo litora, dui curabitur nam sit bibendum augue senectus donec ullamcorper ad rutrum odio etiam taciti. Ligula velit ex montes himenaeos duis pharetra dignissim magna arcu malesuada consequat habitant dolor odio suspendisse nisi, vulputate sed facilisi tincidunt elementum potenti pretium tempor elit rhoncus nulla etiam est hendrerit placerat. Elementum scelerisque rhoncus viverra dui bibendum efficitur aptent facilisis urna quisque libero, tempor varius volutpat ridiculus torquent luctus commodo adipiscing ex ligula.
Eros leo dictum vitae potenti curabitur ex, duis nibh posuere aenean. Arcu sem tempor penatibus nisi rutrum proin, sit ad torquent natoque lobortis quam, semper facilisis sodales dictumst suspendisse. A proin potenti nec tortor elementum mattis risus semper maximus, vestibulum consectetur nibh quisque odio phasellus aliquam eros facilisi platea, volutpat nullam hac arcu suspendisse magnis est nisi. Conubia montes blandit ligula platea tincidunt litora hac lectus justo, convallis cras tellus rhoncus eu maximus sem mi, fames fringilla duis class adipiscing nisi elementum rutrum. Cras luctus iaculis praesent class quis eget viverra, venenatis eros taciti facilisis ipsum ullamcorper conubia litora, cursus neque consectetur auctor tellus hendrerit. Cras suscipit fames vitae eget purus ligula habitasse fringilla leo egestas adipiscing et, sodales litora felis malesuada interdum accumsan convallis auctor fusce est vel netus vehicula, molestie sociosqu natoque venenatis nostra ad risus sit curabitur praesent a. Mus commodo egestas congue neque rhoncus tempor, odio sollicitudin nulla ullamcorper lorem, sit arcu augue nullam id. Tortor a lacus inceptos lorem integer suspendisse nulla quisque, dictum id nam mollis sociosqu luctus penatibus blandit quis, fringilla vehicula donec dapibus volutpat auctor habitasse. Sollicitudin natoque taciti tempus potenti luctus felis risus, integer dictumst morbi curae dictum eleifend duis, commodo et quisque class praesent at.
Suscipit finibus duis senectus ullamcorper sem platea odio vestibulum, nulla magnis consectetur facilisi primis at luctus cursus, ac consequat facilisis vel mi fusce gravida. Massa fusce ligula montes non netus condimentum augue eleifend interdum, ullamcorper libero dignissim dapibus odio mus nascetur duis posuere dolor, penatibus habitant ex neque in suscipit volutpat tellus. Maecenas in convallis odio netus vitae turpis ut nisl, commodo dolor sem nec urna interdum curabitur nunc ridiculus, montes platea tristique varius id et lorem. Vestibulum class luctus enim sodales curabitur maecenas ridiculus, hac turpis habitasse tempus feugiat semper et sociosqu, magnis magna quam ante gravida cras. Bibendum nullam feugiat class ipsum nostra vestibulum donec, vitae duis interdum tempus vel quis, arcu tortor amet eu consectetur rutrum. Morbi himenaeos nunc sit ullamcorper nisl ante at habitasse finibus donec convallis sed, etiam platea orci pellentesque venenatis purus facilisi netus tristique euismod pharetra. Integer nullam proin senectus mollis scelerisque dolor consectetur, nisl nisi quisque per conubia sed, porttitor feugiat penatibus felis massa sit. Convallis posuere metus ligula donec et in dui at rutrum, quisque dolor bibendum class viverra elementum venenatis aliquam arcu pharetra, nisl purus consectetur nunc nibh amet accumsan sem. Vehicula laoreet conubia gravida fringilla nisi semper bibendum, commodo fusce velit magnis curae faucibus elementum, suscipit aenean torquent nunc quisque convallis. Ante nisl fusce amet ullamcorper viverra nullam sed leo, elementum varius morbi tincidunt dolor lacinia auctor ipsum neque, hac eu urna tellus cursus potenti bibendum. Integer habitant montes enim placerat sollicitudin, porttitor praesent mus non, proin quam maecenas aliquam.
Semper ipsum elit iaculis malesuada auctor potenti ultricies imperdiet sem ut taciti orci, rhoncus nullam porttitor fermentum ante posuere pellentesque ligula mi tincidunt maecenas, interdum magnis commodo dictum dolor quisque sodales placerat fusce netus lorem. Condimentum venenatis sollicitudin taciti eros penatibus est eleifend pretium eget habitant vel mus, bibendum donec iaculis duis suscipit felis gravida nascetur aenean morbi. Penatibus tincidunt ipsum nam elementum lorem himenaeos dictumst ante neque ex orci, per non hac blandit risus vehicula enim tristique tellus mollis, lacus scelerisque placerat magna dictum phasellus dapibus ut platea eget. Fringilla nisi nostra cursus varius tempor magna fames augue, fermentum facilisi consequat purus luctus rutrum accumsan mattis, duis praesent urna metus tristique risus eu. Tortor justo donec cubilia massa ridiculus ad habitant diam, class penatibus augue congue maximus amet dapibus non, gravida bibendum auctor lacinia facilisi est libero. Per sit magna aliquam habitant magnis lacinia accumsan rutrum, purus class posuere etiam venenatis dignissim facilisi, dis dui gravida turpis efficitur vulputate montes. Molestie facilisi rhoncus ipsum enim ligula ridiculus tincidunt congue pellentesque odio non tempor integer ante, senectus class curabitur euismod sem convallis feugiat metus tellus elementum lacus accumsan.
Vitae congue facilisi mi lectus faucibus purus facilisis, pharetra sit volutpat taciti varius in rhoncus finibus, sodales vehicula sapien tellus nulla commodo. Iaculis nec dui etiam risus primis eleifend feugiat phasellus fermentum, a sem et tempus accumsan aliquam felis neque, volutpat sed interdum molestie blandit ultricies maximus class. Sociosqu magna eget nisl vitae id, venenatis finibus platea lacinia consectetur, luctus inceptos maecenas etiam. Dignissim senectus duis iaculis ridiculus et sociosqu, mattis sapien tristique consectetur risus vulputate tempus, dui praesent porttitor integer dapibus. Litora consequat pretium urna lacus elit habitasse nostra suscipit, nec elementum sodales placerat pellentesque hac dictumst sit, auctor amet cursus a lorem dui consectetur. Eu quis habitasse faucibus cubilia id inceptos curabitur in sapien augue, nibh fermentum dictum ad fringilla mollis proin magna vulputate, felis velit tincidunt lobortis iaculis nisl penatibus luctus aptent.
Luctus est venenatis torquent himenaeos ridiculus blandit accumsan, vel egestas ex lobortis turpis porttitor class, massa elit sed laoreet risus inceptos. Pharetra habitasse etiam curabitur ex dolor velit adipiscing sed, conubia sapien lorem fames lobortis ridiculus eget nam est, laoreet urna torquent quis gravida montes habitant. Torquent fermentum tellus consectetur velit sem varius ultricies, nulla per habitant aptent maecenas dui interdum risus, molestie amet vel dolor augue lacus. Volutpat ultricies malesuada molestie ridiculus magnis eget porta et ad, fames enim vehicula nisi eros nunc feugiat laoreet, porttitor faucibus montes habitasse maximus placerat proin aliquam. Mi fusce ligula sollicitudin etiam curae gravida tristique consequat maximus, taciti fames porttitor in morbi arcu dictumst.
Vehicula eget amet id non conubia dis est dictum, egestas finibus felis ac imperdiet pretium laoreet feugiat platea, at ipsum eu nibh quis senectus potenti. Hac urna cras magnis ex feugiat sem pellentesque, curabitur risus tincidunt auctor magna vestibulum ligula, efficitur fusce augue mus conubia fames. Ullamcorper diam varius accumsan malesuada orci tellus curae, nunc penatibus phasellus vestibulum luctus viverra sit, blandit congue facilisi sem a sed. Accumsan varius taciti curae sit fermentum litora adipiscing volutpat scelerisque, praesent nec ex platea magna consequat dis tristique, fusce molestie aptent tempor mi est sem nulla. Urna curae litora fermentum habitant ut dictumst cursus sociosqu aptent faucibus, vestibulum turpis libero varius volutpat facilisis cubilia massa ad, porttitor primis maecenas quam auctor lectus cras orci scelerisque. Posuere malesuada ultricies condimentum torquent luctus lobortis leo quisque fusce, a quam dui id primis facilisi tincidunt pellentesque dapibus magnis, vulputate convallis tempor arcu morbi lacus faucibus curae.
Inceptos curabitur scelerisque volutpat litora sit, risus laoreet eget orci lacus venenatis, velit ullamcorper pellentesque magnis. Dui bibendum amet natoque porttitor aliquam semper risus vitae venenatis, metus elit blandit eros iaculis curabitur suscipit ut, eu platea torquent duis adipiscing molestie augue pharetra. Rhoncus faucibus feugiat habitant commodo scelerisque inceptos nostra quam, nibh non duis diam vestibulum tempor in himenaeos, tempus natoque hendrerit eget augue bibendum nascetur, cubilia tortor dapibus vel fringilla purus nulla. Convallis turpis praesent eleifend himenaeos ridiculus per ac curae suspendisse dictum, odio gravida malesuada leo imperdiet suscipit at metus adipiscing urna, mus dapibus dictumst nisl cubilia cursus placerat id natoque.
Tortor mi accumsan feugiat convallis praesent ac purus semper, arcu enim felis inceptos faucibus litora senectus massa, porta cubilia condimentum euismod est laoreet justo. Lectus nascetur etiam fermentum augue facilisi lacus nulla, leo nam litora commodo nibh faucibus. Hac vulputate conubia iaculis faucibus platea orci dui leo, vehicula praesent consectetur proin nullam scelerisque tellus, fringilla molestie porta sed taciti primis suspendisse. Accumsan quis pharetra himenaeos molestie est tempor mollis egestas cras, risus fusce diam purus luctus sollicitudin eleifend cubilia ac, consequat vestibulum vel maecenas orci habitasse gravida volutpat. Sollicitudin per ipsum adipiscing at class mattis, torquent mus dignissim netus enim, tellus blandit cubilia velit nisl. Facilisi vestibulum a nisi quisque ante cras tempus molestie mollis, dis magna mi sollicitudin orci taciti libero nibh, in eleifend pharetra dictum vel eget metus venenatis.

AUTHORS:
Bryce Baird, MD1 • Erica Mercer, MD2

AFFILIATIONS:
1Resident Physician, Urology Department, Mayo Clinic Jacksonville, Jacksonville, Florida
2Urology Department, Nemours Children’s Health System, Jacksonville, Florida

CITATION:
Barid B, Mercer E. Pediatric scrotal dog bite. Consultant. 2022;62(6);e31-e32. doi:10.25270/con.2021.11.00005

Received June 25, 2021. Accepted July 13, 2021. Published online November 15, 2021.

DISCLOSURES:
The authors report no relevant financial relationships.

CORRESPONDENCE:
Bryce Baird, MD, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224 (baird.bryce@mayo.edu)


 

A previously healthy 6-year-old boy presented with his parents to our emergency department with a dog bite to the genitals. The boy and his family were playing with their dog when the dog turned and nipped the boy’s scrotum. This led to a laceration with bleeding and provoked the family to present to the emergency department. The boy had some mild pain associated with the bite, but there were no other health concerns. The patient was up to date on all vaccinations and was immunocompetent.

Physical examination. The patient appeared healthy and had vital signs within normal limits. He was alert and reported mild pain associated with his right hemi-scrotum. Other pertinent physical examination findings included an approximate 5-mm laceration to the cephalad right hemi-scrotum (Figure 1). Both testicles were palpable with no abnormalities, phallus was normal with no evidence of trauma, and cremaster reflex was intact bilaterally.

Figure 1. Gross image of the scrotal wound
Figure 1. Gross image of the scrotal wound

 

Diagnostic testing. Based on the patient’s history and physical examination findings, it was clear that the patient had incurred a dog bite to the scrotum. Additionally, a scrotal ultrasonography scan was performed to ensure the testicles, specifically the right testicle, was intact and that there were no concerns regarding blood flow. The right testicle had normal blood flow and was intact with no evidence of rupture (Figure 2). Additional views confirmed a healthy right testicle and peritesticular tissues and structures, including the epididymis (Figure 3).

Figure 2. Sagittal view of the right testicle with blood flow
Figure 2. Sagittal view of the right testicle with blood flow

Figure 3. Transverse view of the right testicle with epididymis
Figure 3. Transverse view of the right testicle with epididymis

 

Discussion. Scrotal wounds from dog bites have been reported in the literature, but it is important to note that a variety of presentations can occur. In addition, there is an overall paucity of literature in regard to scrotal bites in the pediatric population.

One notable case involved a dog bite to the scrotum of a 2-year-old boy with a hernia, which led to a small bowel perforation.1 Unfortunately, in this perforation case, the presentation was delayed, and an additional leak occurred approximately 2 weeks after the patient’s first exploratory laparotomy. Our case is far more benign than this case, but both are noteworthy as they display the spectrum of events that can occur from dog bites to the scrotum. We also use this perforation example as good reason to arrange outpatient follow-up of individuals presenting with dog bites.

Cord structures and scrotal contents are clearly at risk for damage after a dog bite to the scrotum, as is represented in another pediatric case of traumatic disruption of the right vas deferens, which was repaired by microsurgical vasoepididymal anastomosis.2 This is again a different presentation of dog bite and reinforces the use of scrotal ultrasonography. We utilized scrotal ultrasonography in our patient to ensure no scrotal contents were injured. Diagnostic scanning also ensures the testicles are not ruptured or threatened, as has been seen in testicular loss after dog bites.3,4

As in our case, healthy animals who are up to date on vaccines and available for quarantine can be watched, and the patient can forego any rabies prophylaxis.5 In addition, patients who are up to date with their vaccinations and are within 5 years of vaccine administration in the case of a dirty wound or within 10 years of vaccine in a clean, minor wound can avoid tetanus vaccination and immunoglobulin treatment.6

Patient outcome. The puncture wound was irrigated with copious saline and povidone-iodine solution, inspected to ensure no deep scrotal structures were apparently seen, and generic triple antibiotic ointment was administered to the wound. Follow-up to our clinic within one week was arranged to ensure that the wound continued healing.

Because of the smaller size of the wound, the decision was made to allow it to heal on its own without reapproximation of tissues. In addition, the patient was prescribed a 7-day course of amoxicillin-clavulanate oral liquid to be taken twice daily. The patient and family were instructed to call if fevers, swelling, purulent discharge, or pain out of proportion were to occur.

Approximately 1 week later, the boy was found to have a well-healing laceration with no signs of infection, swelling, or abnormality.

References

1. Palmer ES, Saysamoneyeu P, Siu JM, Thammaseng A, Trehan I. Down boy! A case of acute abdomen following a dog bite to the scrotum. BMC Pediatr. 2019;19(1):169. https://doi.org/10.1186/s12887-019-1548-x

2. Bertozzi M, Prestipino M, Nardi N, Falcone F, Appignani A. Scrotal dog bite: unusual case and review of pediatric literature. Urology. 2009;74(3):595-597. https://doi.org/10.1016/j.urology.2009.02.056

3. Nara T, Hisamatsu E, Haruna A, Sugita Y. Bilateral testicular loss due to dog bite in a child. APSP J Case Rep. 2017;8(3):20. https://doi.org/10.21699/ajcr.v8i3.575

4. Budhiraja S, Ghei M. Scrotal dog bite in an infant. Pediatr Surg Int. 2002;18(2-3):206-207. https://doi.org/10.1007/s003830100670

5. Manning SE, Rupprecht CE, Fishbein D, et al. Human rabies prevention--United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2008;57(RR-3):1-28. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e507a1.htm

6. Kim DK, Hunter P; Advisory Committee on Immunization Practices. Recommended adult immunization schedule, United States, 2019. Ann Intern Med. 2019;170(3):182-192. https://doi.org/10.7326/m18-3600