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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Hard Knot Under The Skin Of A Child Post Dog Scratch A Cause For Concern?

My son was recently scratched on the face by a dog. Most of the scratches were superficial and have already healed to nonexistence, but there were two deep, puncture-like spots on his cheek. It has been a week since the incident happened and the spots are light pink and seem to be healing very nicely, but there is a very hard knot under the skin under the two puncture spots. It does not seem to bother him when I touch the knot and it is most definitely not warm or red. He has had a low grad fever, but he is also cutting teeth. I worry if I let it go too long it may have to be lanced, and being that it s on his face I would rather it not come to that. We will be lucky if he comes out of the dog scratch without a scar. What could this hard spot be? And should I make an appointment to see his pediatrician?
posted on Mon, 9 Feb 2015
Twitter Fri, 20 Feb 2015 Answered on
Twitter Mon, 23 Feb 2015 Last reviewed on
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Pathologist and Microbiologist,  's  Response
Hello and welcome to HCM,
Was the dog scratch deep enough to cause bleeding?
If yes, then tetanus and rabies are of more concern.
A tetanus toxoid needs to be taken.
Animal bites carry the risk of tetanus infection because tetanus bacteria are plentiful in soil and outer environment.
Secondly animal bites and deep scratches carry the risk of rabies if the animal is not vaccinated against rabies.
Anti-rabies vaccine is recommended in all animal bites and immunoglobulin if the animal is rabid or suffering from rabies.
The knot formed under the scratch is not indicative of tetanus or rabies.
It can be due to normal healing process.
Thus, consult your paediatrician for issues relating to tetanus and rabies.
The know like structure is not anything serious but clinical assessment is mandatory.

Thanks and take care
Dr Shailja Puri
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Is Hard Knot Under The Skin Of A Child Post Dog Scratch A Cause For Concern?

Hello and welcome to HCM, Was the dog scratch deep enough to cause bleeding? If yes, then tetanus and rabies are of more concern. A tetanus toxoid needs to be taken. Animal bites carry the risk of tetanus infection because tetanus bacteria are plentiful in soil and outer environment. Secondly animal bites and deep scratches carry the risk of rabies if the animal is not vaccinated against rabies. Anti-rabies vaccine is recommended in all animal bites and immunoglobulin if the animal is rabid or suffering from rabies. The knot formed under the scratch is not indicative of tetanus or rabies. It can be due to normal healing process. Thus, consult your paediatrician for issues relating to tetanus and rabies. The know like structure is not anything serious but clinical assessment is mandatory. Thanks and take care Dr Shailja Puri