journal cme questions

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the emergency department, and surgical irrigation and debridement should be considered for penetrating wounds. Antibiotic coverage is of unknown efficacy but should include broad-spectrum coverage of both gram- negative and gram-positive organisms to cover the typ- ical oral flora of the companion bird. REFERENCES 1. Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JJL. Dog and cat bites to the hand: treatment and cost assessment. J Hand Surg 2006;31A:468 – 473. 2. Kwo S, Agarwal JP, Meletiou S. Current treatment of cat bites to the hand and wrist. J Hand Surg 2011;36A:152–154. 3. Jorn KS, Thompson KM, Larson JM, Blair JE. Polly can make you sick: Pet bird-associated diseases. Cleve Clin J Med 2009;6:235–243. 4. Bowman TA and Jacobson ER. Cloacal flora of clinically normal captive psittacine birds. J Zoo Anim Med 1980;11:81– 85. 5. Doneley RJT. Bacterial and parasitic diseases of parrots. Vet Clin North Am Exot Anim Pract 2009;12:417– 432. 6. Flammer K and Drewes LA. Species-related differences in the inci- dence of gram-negative bacteria isolated from the cloaca of clinically normal psittacine birds. Avian Dis 1988;32:79 – 83. 7. Akhter J, Hossain MT, Islam MT, Siddique MP, Islam MA. Isolation and identification of microflora from apparently healthy caged parrots of Dhaka zoo in Bangladesh. Bangl J Vet Med 2010;8:5–10. 8. Smith KA, Bradley KK, Stobierski MG, Tengelsen LA; National association of State Public Health Veterinarians Psittacosis Compen- dium Committee. Compendium of measures to control Chlamydo- phila psittaci (formerly Chlamydia psittaci) infection among humans (psittacosis) and pet birds, 2005. J Am Vet Med Assoc 2005;226: 532–539. 9. Glaser C, Lewis P, Wong S. Pet-, Animal-, and Vector-borne infec- tions. Pediatr Rev. 2000;21:219 –232. 10. Larson JM, Gerlach SY, Blair JE, Brumble LM, Jorn H, Keels S, et al. Mycobacterium chelonae/abscessus infection caused by a bird bite. Infect Dis Clin Pract. 2008;16:60 – 61. 11. Tripathi AK, Erdmann MWH. Bird-bite infection and pyoderma gangrenosum: A rare combination?. Br J Plast Surg. 2008;61:1409 – 1410. 12. Freshwater A. Why your housecat’s trite little bites could cause you quite a fright: a study of domestic felines on the occurrence and antibiotic susceptibility of Pasteurella multocida. Zoonoses Public Health 2008;55:507–513. 13. Stewardson AJ, Grayson ML. Psittacosis. Infect Dis Clin North Am. 2010;24:7–25. JOURNAL CME QUESTIONS Domestic Bird Bites What is the most common organism isolated from the oral cavity in domestic birds? a. Escherichia coli b. Salmonella c. Pasteurella d. Proteus e. Staphylococcus What is the chance of developing rabies following a domestic bird bite? a. 0% b. 10% c. 25% d. 50% e. 70% To take the online test and receive CME credit, go to http://www.jhandsurg.org/CME/home. TABLE 1. Antibiotic Coverage of Common Oral Pathogens Type of Bird 7,8 Common Bacterial Flora Oral Antibiotic Coverage 1,9,10,11 Parakeets Salmonella sp. Ciprofloxacin 500 mg by mouth every 12 hours OR Staphylococcus sp. Bactrim (Mutual Pharmaceutical Company, Inc., Philadelphia, PA) DS 1 tab by mouth every 12 hours Eschericia coli Cockatoos Bacillus sp. Clindamycin 300–450 mg by mouth every 6–8 hours Parrots Pasteurella sp. Augmentin (GlaxoSmithKlein, Philadelphia, PA) 875 mg by mouth every 12 hours AND Pseudomonas sp. Ciprofloxacin 400 mg by mouth every 8 hours Conures Klebsiella pneumoniae Ciprofloxacin 500 mg by mouth every 12 hours DOMESTIC BIRD BITES 1927 In Brief JHS Vol A, September

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DOMESTIC BIRD BITES 1927

the emergency department, and surgical irrigation anddebridement should be considered for penetratingwounds. Antibiotic coverage is of unknown efficacy butshould include broad-spectrum coverage of both gram-negative and gram-positive organisms to cover the typ-ical oral flora of the companion bird.

REFERENCES1. Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JJL.

Dog and cat bites to the hand: treatment and cost assessment. J HandSurg 2006;31A:468–473.

2. Kwo S, Agarwal JP, Meletiou S. Current treatment of cat bites to thehand and wrist. J Hand Surg 2011;36A:152–154.

3. Jorn KS, Thompson KM, Larson JM, Blair JE. Polly can make you sick:Pet bird-associated diseases. Cleve Clin J Med 2009;6:235–243.

4. Bowman TA and Jacobson ER. Cloacal flora of clinically normalcaptive psittacine birds. J Zoo Anim Med 1980;11:81–85.

5. Doneley RJT. Bacterial and parasitic diseases of parrots. Vet ClinNorth Am Exot Anim Pract 2009;12:417–432.

6. Flammer K and Drewes LA. Species-related differences in the inci-dence of gram-negative bacteria isolated from the cloaca of clinically

TABLE 1. Antibiotic Coverage of Common Oral Pa

Type of Bird7,8 Common Bacterial Flora

Parakeets Salmonella sp.

Staphylococcus sp.

Eschericia coli

Cockatoos Bacillus sp.

Parrots Pasteurella sp.

Pseudomonas sp.

Conures Klebsiella pneumoniae

JOURNAL CME QUESTIONS

JHS �Vol A, Se

7. Akhter J, Hossain MT, Islam MT, Siddique MP, Islam MA.Isolation and identification of microflora from apparently healthycaged parrots of Dhaka zoo in Bangladesh. Bangl J Vet Med2010;8:5–10.

8. Smith KA, Bradley KK, Stobierski MG, Tengelsen LA; Nationalassociation of State Public Health Veterinarians Psittacosis Compen-dium Committee. Compendium of measures to control Chlamydo-phila psittaci (formerly Chlamydia psittaci) infection among humans(psittacosis) and pet birds, 2005. J Am Vet Med Assoc 2005;226:532–539.

9. Glaser C, Lewis P, Wong S. Pet-, Animal-, and Vector-borne infec-tions. Pediatr Rev. 2000;21:219–232.

10. Larson JM, Gerlach SY, Blair JE, Brumble LM, Jorn H, Keels S, etal. Mycobacterium chelonae/abscessus infection caused by a birdbite. Infect Dis Clin Pract. 2008;16:60–61.

11. Tripathi AK, Erdmann MWH. Bird-bite infection and pyodermagangrenosum: A rare combination?. Br J Plast Surg. 2008;61:1409–1410.

12. Freshwater A. Why your housecat’s trite little bites could cause youquite a fright: a study of domestic felines on the occurrence andantibiotic susceptibility of Pasteurella multocida. Zoonoses PublicHealth 2008;55:507–513.

13. Stewardson AJ, Grayson ML. Psittacosis. Infect Dis Clin North Am.

ens

Oral Antibiotic Coverage1,9,10,11

Ciprofloxacin 500 mg by mouth every 12 hours OR

Bactrim (Mutual Pharmaceutical Company, Inc.,Philadelphia, PA) DS 1 tab by mouth every 12 hours

Clindamycin 300–450 mg by mouth every 6–8 hours

Augmentin (GlaxoSmithKlein, Philadelphia, PA) 875 mgby mouth every 12 hours AND

Ciprofloxacin 400 mg by mouth every 8 hours

Ciprofloxacin 500 mg by mouth every 12 hours

Brief

normal psittacine birds. Avian Dis 1988;32:79–83. 2010;24:7–25.

In

Domestic Bird Bites

What is the most common organism isolated fromthe oral cavity in domestic birds?

a. Escherichia coli

b. Salmonella

c. Pasteurella

d. Proteus

e. Staphylococcus

What is the chance of developing rabiesfollowing a domestic bird bite?

a. 0%

b. 10%

c. 25%

d. 50%

e. 70%

To take the online test and receive CME credit, go to http://www.jhandsurg.org/CME/home.

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ptember