Research Information System
2nd Southeast European Congress of Emergency and Disaster Medicine 20 - 22 July 2019 İstanbul, İstanbul, Turkey, 20 - 22 June 2019, (Summary Text)
Introduction
Turtle bites is a very rare environmental injury in emergency department admissions(1).Injuries caused
by turtle bites are seen in more hands(2). Facial injuries are very rare and make our case special.
However, other extremities and trunk injuries have also been reported(3).Children are more often
exposed to turtle bites(4).
Turtle bites are highly risky in terms of causing infections with Salmonella. Other aerobic and anaerobic
bacteria in the oral flora of the turtle may also be the cause of infection(5).In our case, we shared the
treatment of a child who was bitten by a land turtle in nature.
Case
A 5-year-old girl was bitten by a sudden and single swing by a land turtle (Testudo graeca) she found in
the street. She was brought to the emergency department immediately after the bite. There was a 2 cm
vertical skin wound on the left eye lateral side.(Figure 1) Vital signs were stable upon arrival (Blood
pressure:100/60 mm Hg, pulse:75 beats/min, oxygen saturation:% 97, body temperature:36.7 C,
breathing count:16/min). After treatment with tetanus vaccine and 0.5g IV cefazolin (1st generation
cephalosporin), the wound site was cleaned by irrigation. The wound was primary sutured with an
appropriate analgesia and anesthesia. Infectious diseases specialist was consulted. Five days of
empirical antibiotherapy (amoxicillin-clavunate), analgesic treatment and daily wound care were
recommended and the patient was discharged with outpatient treatment. There were no wound
complications during follow-up. After 10 days, sutures were removed and wound healing was observed.
Conclusion
Although they are calm-looking, turtles can be aggressive when they feel themselves in danger. In cases
where there is a need to contact, it should be held away from the head with gloves. As in our case, small
lacerations can be treated as outpatient. All turtle bites require tetanus and empirical therapy should be
initiated with broad-spectrum antibiotics. Although the wound healed without any problem in this case.
Infected wounds should be carefully evaluated for cellulitis and necrotizing fasciitis and consultation
from infection specialists and surgical specialists should be requested.
FİGURE 1: Turtle bite on the face