Match each pediatric patient's clinical exposure scenario with the most appropriate post-exposure prophylaxis or immunologic management step.
- A 2-day-old neonate whose mother developed a disseminated vesicular rash, confirmed as varicella, 24 hours prior to delivery.Administer varicella-zoster immune globulin (VZIG) to the infant.
- A 4-month-old healthy, unimmunized infant whose teenage sibling was diagnosed with measles 3 days ago.Administer intramuscular human immune globulin (IG).
- An 8-year-old child with no prior immunizations who sustained a deep, dirt-contaminated puncture wound to the foot.Administer tetanus-diphtheria-acellular pertussis (Tdap) vaccine and tetanus immune globulin (TIG).
- A 10-year-old child who sustained an unprovoked bite from a wild raccoon that subsequently fled into the woods.Administer human rabies immune globulin (HRIG) and initiate the rabies vaccine series.
Answer
The correct matches require applying specific post-exposure prophylaxis guidelines: the neonate exposed to peripartum maternal varicella requires VZIG; the 4-month-old exposed to measles requires IG; the unimmunized child with a dirty wound requires both Tdap and TIG; and the raccoon bite victim requires HRIG and the rabies vaccine series.
Each correct pairing accurately reflects the established guidelines for pediatric post-exposure prophylaxis. VZIG is indicated for peripartum varicella exposure; intramuscular IG is the standard of care for measles exposure in infants <6 months; severe wounds in unimmunized children require both Tdap and TIG; and untestable high-risk wild animal bites necessitate full rabies PEP (HRIG + vaccine).
Step-by-Step Solution
Key Concept
Post-Exposure Prophylaxis (PEP) in Pediatric Populations