Dehghani, M.

Dehghani, R.

Kassiri, H.

English

kashan university of medical sciences

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Arch Clin Infect Dis. 2020 February; 15(1):e97499.
Published online 2020 March 1.
doi: 10.5812/archcid.97499.
Letter
A Brief Review on Biting/Stinging of Animals and Its Risk of Infection
Rouhullah Dehghani 1, Hamid Kassiri 2, * and Mousa Dehghani 3
1Social Determinants of Health Research Center, Department of Environment Health, Kashan University of Medical Sciences, Kashan, Iran
2Department of Medical Entomology and Vector Control, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3Department of Environmental Science, Faculty of Natural Resources, Isfahan University of Technology, Isfahan, Iran
*Corresponding author: Department of Medical Entomology and Vector Control, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Email:
hamid.kassiri@yahoo.com
Received 2019 August 26; Revised 2020 January 15; Accepted 2020 February 01.
Keywords: Spider, Bite, Sting, Scorpion, Velvet Ant, Snake
Dear Editor,
Bites of animals and their problems in humans and
livestock cause significant health and economic losses in
countries (1). Bites and stings of animals usually occur in
the defense of their survival. In other cases, biting and
stinging may be done in an attempt to obtain food (2). The
cases of humans bitten by animals, in particular during
poisonous occasions, are often due to animals’ sense of
fear and risk caused by the known instinctive behavior of
most animals, including snakes and scorpions (Figure 1) (3,
4).
Bites of animals, in addition to local injury, will cause
the risk of poisoning and infection. Considering the im-
portance of local or systemic infections due to bites and
stinging of some venomous animals, it is necessary to raise
the awareness of physicians and medical staff about this is-
sue, therefore, this article was presented.
Most snakes cause infection due to oral microbial flora
(5-7). Snake bites are especially important in the rural ar-
eas of tropical and subtropical countries located in Africa,
Asia, Latin America, and the Pacific. It is estimated that at
least 421000 bites and 20000 deaths worldwide occur ev-
ery year due to snake bites (8). More than 10 million people
are being treated annually in different regions around the
world due to bites. Animal bites and diseases caused by it
are of the economic health problems in Iran, and almost
all regions have this problem. According to the statistics
published by the Center for Disease Management, the dis-
tribution of animal bite cases in the country has been re-
ported to be 100 - 450 per 100000 people (9). On this ba-
sis, it can be estimated that there are 800000 to 3600000
animal bites in Iran, annually. Bites of animals can cause
local to systemic damages. In some cases, secondary in-
fections have been observed due to venomous and non-
venomous snake bites. Wound and necrosis is created at
the site of the bite of some poisonous snakes, especially
vipers, which increases the risk of secondary fungal and
bacterial infections (10, 11). The snakes’ mouth flora varies
between different species as well as different geographic
regions. Even some researchers find seasonal changes ef-
fective in snakes’ mouth flora (12, 13). Bacterial species have
been widely identified from the mouth of snakes, the most
important of which are Pseudomonas aeromonas, staphylo-
coccus aureus, Escherichia coli, Proteus, Clostridium, Entero-
coccus and coagulase-negative Staphylococcus, Acinetobac-
ter, klebsiella, and Shigella (14, 15).
Arachnida is one of the most important poisonous
arthropods, among which scorpions and spiders are more
important than others (Figure 2) (16). Some Arachnida
species, such as Solpugids are hunter beasts larger than
spiders, but they have no poison unlike spiders. They cause
fear because of aggressive behavior. The Solpugids bite to
defend themselves, which may lead to wounds. The con-
tamination of these wounds with soil microbial agents
may cause infection (17). Scorpions cause stings more
than other poisonous animals in Iran; they are more abun-
dant in tropical areas. Due to the type of climate, Iran is
very rich in scorpions, so far, scorpions from three fami-
lies have been reported in Iran. Iran is among the coun-
tries where many species of scorpions, especially danger-
ous ones, have been reported (18). A scorpion sting causes
infection as well as poisoning. Topical complications, most
commonly cellulitis, sepsis, abscess, and systemic such as
infection and endocarditis have been reported (19-21).
A large part of the bites is due to poisonous animals
that are usually more considered in the therapeutic area
because of fear of the dangers of poison. In the problem of
animal bites, in addition to the effects of poison and local
Copyright © 2020, Archives of Clinical Infectious Diseases. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial
4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the
original work is properly cited.
Uncorrected Proof
Dehghani R et al.
Figure 1. Left, Macrovipera lebetina; Right, Odontobuthus doriae (photoes prepared by R. Dehghani)
Figure 2. Erythema and necrosis after brown widow spider bite in the medial elbow
(photo prepared by R. Dehghani)
injuries such as wounds and trauma, other aspects must
be considered; one of these aspects is the risk of infection,
which is a major issue for people with immune system de-
ficiency or those taking immunosuppressive drugs (22, 23).
Therefore, physicians and the treatment team should be
aware of the possibility of infection in these patients when
faced with bites and stings of poisonous animals. Given
the high animal bite rate in Iran, all aspects of this inclu-
sive problem, including the effects of poison, the risk of in-
fection, and the prevention and reduction of animal stings
and bites, should be addressed through the implementa-
tion of a coherent national and regional program (24-26).
In Iran, biting and stinging of venomous animals
such as Viperidae family snakes, brown widow spider,
and Hemiscorpius leptrus scorpion, can cause tissue necro-
sis, which is due to the fact that they have cytotoxic and
hemolytic agents in their venom, and may result in local or
systemic infection. Therefore, physicians and medical staff
have to have sufficient knowledge of the animal venom
properties in their own workplace.
Footnotes
Authors’ Contribution: Rouhullah Dehghani, Hamid
Kassiri, and Mousa Dehghani developed the original idea
and the protocol, abstracted and analyzed data, and wrote
the manuscript.
Conflict of Interests: No conflict of interest is reported.
Funding/Support: None is declared by the authors.
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Arch Clin Infect Dis. 2020; 15(1):e97499. 3


A brief review on biting/stinging of animals and its risk of infection

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