may transmit rabies, which is almost always fatal if left untreated. Human bites are themselves capable of doing great flesh damage, but are particularly known for spreading communicable diseasesInvoluntary biting injuries due to closed-fist injuries from fists striking teeth (referred to as reverse bite injuries) are a common consequence of fist fights. These have been termed "fight bites". Injuries in which the knuckle joints or tendons of the hand are bitten into tend to be the most serious. Teething infants are known to bite objects to relieve pressure on their growing teeth, and may inadvertently bite peoples hands or arms while doing so. Young children may also bite people out of anger or misbehaviour, although this is usually corrected early in the childs life. Reverse bite injury
A reverse bite injury (also called a clenched fist injury, closed fist injury, or fight bite) results when a person punches another person in the face, and the skin (and sometimes tendons) of their knuckles are cut against the teeth of the person they are punching. The proximity of the wound is often located over the metacarpophalangeal joint resulting in tendon injury.The medical treatment of this injury is similar to those of a human bite, but may also involve damage of the underlying tendons.These injuries should be managed as other human bites: wound irrigation and antibiotics are essential as human saliva can contain a number of bacteria. The nature of these injuries is such that even if the injury is optimally managed, poor outcomes may still occur.
Treatment
Historically, acute MS was a fatal disease, with death occurring within a year of onset, often secondary to extensive brain stem demyelination. Treatment recommendations, based on anecdotes, include plasma exchange in conjunction with high-dose glucocorticoids(e.g., 1 to 2 g/day of methylprednisolone for 10 days followed by a slow taper). For patients who survive the acute attack, follow-up treatments include immunosuppression (monthly mitoxantrone or cyclophosphamide) either alone or in combination with IFN beta or GA (glatiramer acetate). Prognosis
Marburg variant of MS is an acute fulminant demyelinating process which in most cases progresses inexorably to death within 1–2 years. However, there are some reports of Marburg MS reaching stability by three years. See also
Malignant multiple sclerosis
Tumefactive multiple sclerosis

References


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