Match each clinical exposure scenario with the most appropriate post-exposure prophylaxis (PEP) regimen.
- A 28-year-old surgical resident sustains a deep hollow-bore needlestick injury from a patient with untreated HIV.Tenofovir-emtricitabine and raltegravir for 28 days
- A 40-year-old unvaccinated man awakens to find a bat flying in his bedroom, with no visible bite marks on his skin.Human rabies immune globulin and rabies vaccine series
- A 32-year-old pregnant woman at 14 weeks gestation has prolonged close household contact with a patient newly diagnosed with meningococcal meningitis.Intramuscular ceftriaxone (single dose)
- A 29-year-old susceptible pregnant woman at 20 weeks gestation has face-to-face contact with a child who develops a chickenpox rash 24 hours later.Varicella-zoster immune globulin (VZIG)
Answer
The resident with HIV exposure receives a 28-day 3-drug ART regimen. The man with bat exposure receives rabies immune globulin and the vaccine series. The pregnant woman with meningococcal exposure receives a single dose of intramuscular ceftriaxone. The susceptible pregnant woman with varicella exposure receives varicella-zoster immune globulin.
Each exposure scenario requires a targeted post-exposure prophylaxis protocol based on the pathogen's transmission risk and the patient's physiological state. Standard regimens must be altered for pregnancy (e.g., utilizing ceftriaxone for meningococcus and immune globulin for varicella) while aggressive, multi-modal therapies are maintained for high-lethality exposures (e.g., 3-drug ART for HIV, and RIG plus vaccine for rabies).
Step-by-Step Solution
Key Concept
Post-exposure prophylaxis (PEP) protocols for high-risk infectious exposures, emphasizing regimen modifications for pregnant patients.