STARTLING TRUE CASES OF BITE ATTACKS, RESULTING INFECTIONS, AND ENSUING TREATMENTS-- From ticks, ants, and flying bats to elephant seals, Komodo dragons, rhesus macaques, and deadliest of all, humans. We've all been bitten. And we all have stories. The bite attacks that Pamela Nagami, M.D., has chosen to write about in Bitten take place in big cities, small towns, and remote villages around the world and throughout history, locales as familiar as New York or Hollywood, or exotic as Africa, the Middle East, or Indonesia. They include a six-year-old girl who descended into weeks of extreme lassitude from a tick bite; a diabetic in the West Indies who awoke to find a rat eating two of his toes; a California man who developed flesh-eating strep following a penile bite; and more. With reports from medical journals, case histories, colleagues, and her own twenty-five-year career as a practicing physician and infectious diseases specialist, Pamela Nagami offers readers intrigued by infection, disease, and mesmerized by creatures in the wild a compulsively readable narrative that is entertaining, sometimes disturbing, and always engrossing.

Pamela Nagami, M.D., is a practicing physician in internal medicine and infectious diseases and a clinical associate professor of medicine at The David Geffen School of Medicine at UCLA. She lives with her husband in Encino, California.

Preface

Acknowledgments

xiii

1 Invincible Invaders

(17)

2 Fangs in the Dark

(22)

3 Stingers from the Sea

(16)

4 Beautiful, Deadly Cones

(10)

5 The Limbless Ones

(21)

6 Silent Stowaways

(14)

7 Nightmare

101

(25)

8 Sponge Face and Black Fever

126

(27)

9 New York, Summer 1999

153

(16)

10 "The Jaws That Bite"

169

(22)

11 Rage

191

(16)

12 Bitten

207

(14)

13 Menagerie

221

(23)

14 Monkey Business

244

(24)

15 Human Bites

268

(19)

Conclusion

287

(2)

Glossary

289

(8)

References

297

(42)

Index

339

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Excerpts

It was at the end of December that Alfred first noticed one and then two red bumps under the right side of his chin. He gave them little thought at first. They seemed like pimples from shaving irritation, or maybe ingrown hairs. But the bumps didn't go away. Instead, though painless, they gradually got larger. Their tops broke open to form shallow ulcers, which drained a small amount of yellow fluid.... At the end of January, he became aware of a vague swelling just under the point of his chin, also painless. Over the next week it slowly enlarged to the size and firmness of a hard-boiled egg yolk. The ulcers had also gotten bigger; each was now about a quarter inch across.... On February 1, 2003, Alfred came to the walk-in clinic at my hospital.... He showed the ulcers and the swelling under his chin to a physician on duty.... I was in my office when my beeper went off. The doctor who answered the phone didn't mince words. "I've got a seventy-two-year-old guy down here who was in a jungle in Peru and now has a weird ulcer He says he thinks it might be leishmaniasis." I had never seen a case of leishmaniasis, but I knew that the American form, left untreated, could eat up the middle of a person's face, starting with his nose. The Portuguese in Brazil call the condition espundia, or sponge, because that's what the patient's face becomes---a ragged, porous hole, like a sea sponge.

"I'll be right down," I said.

Copyright 2004 by Pamela Nagami

Excerpted from Bitten: True Medical Stories of Bites and Stings by Pamela Nagami
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.