or fight bite) results when a person punches another person in the face, and the skin (and sometimes tendons) of their knuckles are cut against the teeth of the person they are punching. The proximity of the wound is often located over the metacarpophalangeal joint resulting in tendon injury. The medical treatment of this injury is similar to those of a human bite, but may also involve damage of the underlying tendons. These injuries should be managed as other human bites: wound irrigation and antibiotics are essential as human saliva can contain a number of bacteria. The nature of these injuries is such that even if the injury is optimally managed, poor outcomes may still occur. Arthropods The bites of arthropods have some of the most serious health consequences known. Mosquito bites transmit serious disease and result in millions of deaths and illnesses in the world. Ticks also transmit many diseases such as Lyme disease. Spider bite Insect bites and stings Flea bites are responsible for the transmission of plague. Mosquito bites are responsible for the transmission of dengue fever and malaria. Leech bite Mechanism Trauma A natural consequence of a bite is tissue trauma at the site. Trauma may consist of scratching, tearing, punture or laceration of the skin, hematoma (bruising), embedding of foreign objects, for example a tooth or hair, damage to or severing of underlying structures such as connective tissue or muscle, amputations, and the ripping off of skin and hair. If major blood vessels are damaged, severe blood loss can occur. Infection Pathogen organisms can be introduced into the bite. Some of the pathogens can originate from the mouth of the 'biter', the substrate onto which the injured person or animal can fall or from the naturally occurring microorganisms that are present on the skin or hair of the animal. The advent of antibiotics improved the outcome of bite wound infections. Rabies Animal bites where skin has been penetrated, most commonly by dogs and bats, transmit rabies to humans. Rabies from other animals is rare. If the animal is caught alive or dead with its head preserved, the head can be analyzed to detect the disease. Signs of rabies include foaming at the mouth, growling, self-mutilation, jerky behavior, red eyes, and hydrophobia. If the animal cannot be captured, preventative rabies treatment is recommended in many places. Several countries are known not to have native rabies, see