Match each clinical scenario describing a high-risk infectious exposure with the most appropriate post-exposure prophylaxis (PEP) or management strategy.
- A healthcare worker with a documented anti-HBs titer of <10 mIU/mL after one complete primary vaccination series sustains a percutaneous needlestick from an HBsAg-positive patient.Administer Hepatitis B immune globulin (HBIG) and initiate a second hepatitis B revaccination series.
- A spelunker who received a complete pre-exposure rabies vaccination series 4 years ago is bitten by a bat while exploring a cave.Administer rabies vaccine on days 0 and 3 only; withhold human rabies immune globulin (HRIG).
- A surgical resident sustains a deep scalpel laceration during an operation on an HIV-positive patient with an unknown viral load.Initiate a 3-drug antiretroviral regimen (e.g., tenofovir-emtricitabine plus dolutegravir) for 4 weeks.
- A 20-year-old woman taking combined oral contraceptives is a close household contact of a roommate recently diagnosed with Neisseria meningitidis meningitis.Administer a single dose of oral ciprofloxacin or intramuscular ceftriaxone.
Answer
Match the HBV non-responder to HBIG + revaccination; the previously rabies-vaccinated patient to vaccine on days 0 and 3 only; the HIV occupational exposure to 28 days of 3-drug ART; and the oral contraceptive user exposed to meningococcus to ciprofloxacin or ceftriaxone.
Each high-risk exposure corresponds to a highly specific, evidence-based post-exposure protocol that accounts for prior host immunity, medication interactions, and occupational risk.
Step-by-Step Solution
Key Concept
Guideline-concordant post-exposure prophylaxis for specific high-yield occupational and environmental infectious exposures.
Estimated Time:2m 0s