[Question #1874] Risk Assessment

43 months ago

Dear Doctors,


Thank you for taking my question. Eight days ago I was in a bar minding my own business. A woman whom I've seen there before and who seems to be a regular there called me over to talk to her. As she was acting drunk, I didn’t want to go over. But I didn't want to be rude and ignore her. So I ended up talking to her briefly. 


As I was ready to move away, she took my hand and starting kissing it and licking my fingers. I wasn't worried about this, but then she started biting down on my fingers and knuckles. This is when I got nervous because I could feel her teeth put pressure on my skin. There was a point when I could feel that she bit down hard and clenched my skin. 

When I looked at my hand, I did not see any blood or bleeding. The area of skin between two of my fingers and the knuckle was puffy. I saw small teeth marks on my skin, but I didn't see any blood. I went to the bathroom but of course there was no soap in the dispenser. So I could only rinse my hands with water. For the next 48 hrs, I could still see some redness and small marks. There was soreness and some slight pain when I touched the area. Eventually, this all went a way by the third day.


Yesterday morning, however, I noticed there were small red, raised bumps scattered on my skin in the area where she was biting (like tiny reddish pin pricks scattered randomly in this area). My questions are:


1) Did this episode place me at risk for HIV?  

2) Did this episode place me at risk for Hepatitis B or C? 

3) How long is the hepatits B vaccine good for? I had the Hep B vaccine 10-15 years ago.

4) Do I need to get tested for HIV, Hep B, or Hep C?

4) Would TB be transmitted this way?

Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago

Welcome to our Forum.  I'll be glad to comment.  (Parenthetically, what a strange encounter).   In general if the skin is not broeken (as opposed to bruised which seems to be the case for you), there is really no risk for infection with any blood borne pathogen (HIV, hepatitis, etc.).  Even if the skin is broken, the infection risk is less for these pathogens than from bacterial infections originating form inoculation of the bacteria in the mouth.


1) Did this episode place me at risk for HIV?  

See above, no.


2) Did this episode place me at risk for Hepatitis B or C? 

Once again, no.


3) How long is the hepatits B vaccine good for? I had the Hep B vaccine 10-15 years ago.

Glad to hear you were vaccinated.  As best we know, the protection against infection provided by the hepatitis vaccine is lifelong.


4) Do I need to get tested for HIV, Hep B, or Hep C?

I see no need for testing related to this event.


4) Would TB be transmitted this way?

Absolutely not.  The TB bacteria are not in the mouth or in oral secretions.


I hope these comments are helpful.  Take care.  EWH


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43 months ago
Dr. Hook,

Thank you very much for your time and for your reply.  Yes, a strange encounter. Not the nicest of establishments I guess and needless to say I won't be going back there ever again. Just two quick follow up question:

1) As I didn't notice any obvious bleeding or blood following this event, could she have caused microscopic or small breaks in the skin that would put me at risk for HIV, Syphilis, or any of the Hep viruses? Or does no blood = no break in the skin?

2) Lastly, would my primary doctor be able to tell if there was any bacterial infection caused by mouth bacteria, by looking at my hand/skin? (I have an appointment coming up) 

Thanks again
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
1.   I would not worry about undetected cuts, scrapes, or breaks in the skin. To paraphrase your statement, no blood, no worries. 

2.   At this point if you are not experiencing redness, swelling, or progressing pain at the area of the bite and into your hand I would not worry about infection from mouth bacteria. It is often said in medical circles that's the human mouth is the dirtiest orifice in the human body and it is for that reason that human bites can cause serious infections.   How do you sustained an infection from the encounter you described there would be obvious signs and symptoms at this time. I would not worry. 

Hope this helps. EWH
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