Match each clinical exposure scenario with the most appropriate post-exposure prophylaxis or next step in management.
- A 20-year-old college student who shares a dormitory room with a patient newly diagnosed with meningococcal meningitis.Administration of oral ciprofloxacin, oral rifampin, or intramuscular ceftriaxone.
- An unvaccinated healthcare worker who sustains a deep needlestick injury from a patient with chronic hepatitis B infection.Administration of hepatitis B immune globulin and initiation of the hepatitis B vaccine series.
- A surgeon who sustains a percutaneous scalpel injury while operating on a patient with untreated HIV infection.Initiation of a three-drug antiretroviral therapy regimen for 28 days.
- A camper who awakens in a closed tent to find a bat flying around, with no identifiable bite marks.Administration of human rabies immune globulin and initiation of the rabies vaccine series.
Answer
The correct matches align each specific exposure with its guideline-directed post-exposure prophylaxis regimen. Meningococcal close contacts receive ciprofloxacin, rifampin, or ceftriaxone. Unvaccinated HBV exposures require HBIG and the HBV vaccine. High-risk occupational HIV exposures necessitate a 28-day course of three-drug antiretroviral therapy. Unrecognized bat exposures while sleeping warrant rabies immune globulin and the rabies vaccine.
Each clinical scenario presents a classic indication for a specific post-exposure prophylaxis protocol. Meningococcal contacts require antibiotics that achieve high concentrations in respiratory secretions. Unvaccinated individuals exposed to HBV require both active and passive immunization. Occupational HIV exposure warrants a 28-day course of triple-drug ART. Individuals sleeping in a room with a bat are treated as having a potential rabies exposure and require both HRIG and the rabies vaccine.
Step-by-Step Solution
Key Concept
Guideline-directed post-exposure prophylaxis (PEP) for common and high-risk infectious pathogens.