Donkey Bite Leading to a Catastrophic Outcome: Bilateral Visual Loss


Ophtalmic Plastic and Reconstructive Surgery Unit, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, IR Iran



In this report we present a case of severe facial injury due to a donkey bite. Immediate repair with surgical flaps was performed. No significant complication was observed at the time of surgery or during follow up and the result was acceptable. Animal bites are relatively frequent and most often are done by dogs. Besides dogs, other animals such as cats, horses and donkeys may be responsible for this type of injuries. Although donkey bites to the facial area are very rare, they can cause severe and life-threatening injuries. Early management of facial injuries caused by animal bites is acceptable nowadays and guarantees satisfactory outcome.


1. Ullah F, Tahir M, Aslam M. Mammalian bite injuries to the head and neck region. J Coll Physicians Surg Pak. 2005;15(8):485–8. [PubMed: 16202360].
 2. Bernardo LM, Gardner MJ, Rosenfield RL, Cohen B, Pitetti R. A comparison of dog bite injuries in younger and older children treated in a pediatric emergency department. Pediatr Emerg Care. 2002;18:247–9. doi: 10.1097/00006565-200206000-00024.
 3. Ugboko VI, Olasoji HO, Ajike SO, Amole AOD, Ogundipe OT. Facial injuries caused by animals in northern Nigeria. Br J Oral Maxillofac Surg. 2002;40(5):433–7. doi: 10.1016/S026643560200181X.
 4. Lewis KT, StilesM.Management of cat and dog bites.Am Fam Physician. 1995;52(2):479–85. [PubMed: 7625323] 489-90.
 5. Osterlund A, Nordlund E. Wound infection caused by Staphylococcus hyicus subspecies hyicus after a donkey bite. Scand J Infect Dis. 1997;29(1):95. [PubMed: 9112308].
 6. Hussain G, Thomson S, Zielinski V. Nasal amputation due to human bite: microsurgical replantation. Aust N Z J Surg. 1997;67(6):382–4. [PubMed: 9193275].
 7. Tajima S, Ueda K, Tanaka Y. Successful replantation of a bitten-off nose by microvascular anastomosis. Microsurgery. 1989;10(1):5–7. [PubMed: 2725256].
 8. Christo D. Nasal amputation due to donkey bite: immediate and late reconstruction with a forehead flap. Shipkov Injury Extra. 2004;35:85– 90. doi: 10.1016/j.injury.2004.06.011.
 9. Gonnering RS. Ocular adnexal injury and complications in orbital dog bites. Ophthal Plast Reconstr Surg. 1987;3(4):231–5. [PubMed: 3154600]. 10. Erickson BP, Cavuoto K, Rachitskaya A. Zone 3 ruptured globe from a dog bite. J AAPOS. 2015;19(1):89–90. doi: 10.1016/j.jaapos.2014.09.011. [PubMed: 25727600].
 11. Prendes MA, Jian-Amadi A, Chang SH, Shaftel SS. Ocular Trauma From Dog Bites:Characterization, Associations, and Treatment Patterns at a Regional Level I Trauma Center Over 11 Years. Ophthal Plast Reconstr Surg. 2015;32(4):279–83. doi: 10.1097/IOP.0000000000000501.
 12. Ugboko VI, Olasoji HO, Ajike SO, Amole AO, Ogundipe OT. Facial injuries caused by animals in northern Nigeria. Br J Oral Maxillofac Surg. 2002;40(5):433–7. [PubMed: 12379192].
 13. Jones NP. Perforating eye injuries caused by dog bites. J R Soc Med. 1990;83(5):332–3. [PubMed: 2380952].
 14. Lemperle G, Exner K. [Primary management of fresh bite injuries of the face]. Langenbecks Arch Chir. 1987;372:709–12. [PubMed: 3431292]. 15. Seguin P, Beziat JL, Freidel M. [Amputation of the point of the nose in children due to a dog bite. Repair with a Washio flap. Longterm results]. Rev Stomatol Chir Maxillofac. 1986;87(3):153–6. [PubMed: 3464071].
 16. Van Geertruyden JP. Earlobe reconstruction with a reverse-flow chondrocutaneous flap. Br J Plast Surg. 2002;55(3):253–5. doi: 10.1054/bjps.2002.3817. [PubMed: 12041982].
 17. Steinkogler FJ. Reconstruction of the lower lid. Br J Ophthalmol. 1984;68(7):507–10. [PubMed: 6733076].
 18. Patel KG, Sykes JM. Concepts in local flap design and classifi- cation. Oper Tech Otolaryngol Head Neck Surg. 2011;22:13–23. doi: 10.1016/j.otot.2010.09.002.
 19. Ebrahimi A, Ashayeri M, Rasouli HR. Comparison of Local Flaps and Skin Grafts to Repair Cheek Skin Defects. J Cutan Aesthet Surg. 2015;8(2):92–6. doi: 10.4103/0974-2077.158444. [PubMed: 26157308].