A Case Report of Management of Camel Bite Injury in the Maxillofacial Region

Mohsen  Barzegar; Hamed  Gheibollahi; Reza  Mazloomi

doi:10.18502/ssu.v33i7.19833

Mohsen Barzegar Department of Oral and Maxillofacial Surgery, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Hamed Gheibollahi Department of Oral and Maxillofacial Surgery, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Reza Mazloomi Department of Oral and Maxillofacial Surgery, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

DOI: https://doi.org/10.18502/ssu.v33i7.19833

Keywords: Camel Bite, Parotid Duct injury, Zygomatic Arch fracture, Facial Nerve, Antibiotic therapy, Rabies prophylaxis.

Abstract

Introduction: Camel bites are relatively rare, but they can lead to severe maxillofacial injuries. Because of the unique oral flora of camels in contrast to non-domesticated animals, the choice of antibiotic and wound closure strategy is critical. Moreover, the simultaneous involvement of deep structures such as the parotid duct, facial nerve branches, and the facial skeleton makes management more challenging.

Case Report: A 23-year-old male arrived with a camel bite to the right of his face affecting the preauricular and perimandibular regions The laceration were approximately 15 cm in length, with a suspected parotid duct injury. The wound was extensively irrigated, tetanus toxoid was given, and rabies post-exposure prophylaxis was initiated. A CT scan showed a comminuted fracture of the zygomatic arch, along with temporal and possible buccal injury to the branches of the facial nerve. The patient received ciprofloxacin and metronidazole, and wound closure was delayed during infection surveillance. A parotid duct repair was conducted using an intraoral approach. Conventional stenting was not feasible because of inflammation; therefore, a neonatal Foley catheter was used as a temporary stent for 14 days. Pressure dressings and anti-sialogogue therapy were administered. No salivary leakage, infection, or sialocele formation was observed. At the 2-week, 1-month, and 3-month follow-ups, no signs of infection or sialocele, and mouth opening improved to approximately 35 mm.

Conclusion: This report emphasizes that in camel bite injuries with concomitant skeletal and parotid duct damage, appropriate antibiotic therapy, delayed closure when indicated, and innovative use of accessible tools such as a neonatal Foley catheter for duct stenting can lead to positive outcomes and prevent complications such as infection and sialocele.