Ward Round - Crocodile bites in Malawi: microbiology and surgical management

Malawi Medical Journal; 21(1):29 - 31 March 2009

It's funny the papers you find yourself looking through. I never imagined I'd be thumbing through the Malawi Medical Journal. Recently I was trying to find a study which confirmed the main markers for crocodile attacks, namely a pick up truck, dog, alcohol, male, a gun and of course the crocodile itself. I found myself distracted by the microbiological element of this paper as I didn't realise the oral flora of wild crocodiles had been confirmed. The several case studies confirm what we already know, that crocodile bites are messy affairs with lots of crush injuries, partial and complete amputations. What I found particularly interesting was the quite profound haemolysis associated with the highly contaminated wounds with the unusual combinations of bacteria in the crocodile's mouth and the marine environment. The authors finally give some useful recommendations on antibiotic use if you ever find yourself managing a survivor of a crocodile bite!!