Goat Bite in a 4-Year-Old Boy

November 1, 2006

A 4-year-old boy was bitten on the right index finger by a goat at a petting zoo. The bite created 2 superficial 2-mm open wounds. One of the lesions developed into an indurated 8-mm nodule during the following week. A second nodule developed about 5 days later. The boy was seen by his physician 2 weeks after the bite wounds occurred. At that time, an 8-mm umbilicated nodule and a satellite papule were present.

THE CASE: A 4-year-old boy was bitten on the right index finger by a goat at a petting zoo. The bite created 2 superficial 2-mm open wounds. One of the lesions developed into an indurated 8-mm nodule during the following week. A second nodule developed about 5 days later. The boy was seen by his physician 2 weeks after the bite wounds occurred. At that time, an 8-mm umbilicated nodule and a satellite papule were present.

Eighteen days after the child was bitten, an erythema multiforme-like rash developed on his distal extremities. This rash resolved about a week later.

Which of the following diagnostic possibilities is the most likely?

• A. Pyoderma gangrenosum

• B. Pyogenic granuloma

• C. Orf with erythema multiforme

• D. Herpetic whitlow

• E. Milkers nodule

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. . . or look for the answer in the December issueof Consultant For Pediatricians.