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Difficulty: MediumInfectious Diseases

Match each clinical exposure scenario with the most appropriate post-exposure prophylaxis (PEP) regimen.

  • A susceptible healthcare worker sustains a needlestick injury from a patient with confirmed active Hepatitis B infection.Administer Hepatitis B immune globulin (HBIG) and initiate the Hepatitis B vaccination series.
  • A pregnant woman at 18 weeks gestation with negative varicella IgG antibodies is exposed to a household contact with active chickenpox.Administer Varicella-zoster immune globulin (VZIG) only.
  • A camper is bitten by an unprovoked wild skunk that immediately escapes into the brush and cannot be tested.Administer human rabies immune globulin (HRIG) and initiate the rabies vaccination series.
  • A college student has close, prolonged respiratory contact with a roommate newly diagnosed with invasive meningococcal disease.Administer a single dose of oral ciprofloxacin or a short course of oral rifampin.

Answer

The correct matching aligns Hepatitis B exposure in a susceptible host with HBIG plus the HBV vaccine; varicella exposure in a non-immune pregnant woman with VZIG only; high-risk wildlife bites with HRIG plus the rabies vaccine; and meningococcal close contact with oral ciprofloxacin or rifampin chemoprophylaxis.
Appropriate post-exposure prophylaxis prevents progression to active disease by intervening during the incubation period. Naive hosts exposed to Hepatitis B or Rabies require immediate combined active-passive immunization (vaccine + immunoglobulin). Non-immune pregnant women exposed to varicella require passive immunization (VZIG) because live vaccines are contraindicated. Close contacts of meningococcal disease require targeted bacterial chemoprophylaxis (ciprofloxacin, rifampin, or ceftriaxone) to eliminate nasopharyngeal carriage before systemic invasion occurs.

Step-by-Step Solution

1
Analyze the specific exposure pathogen and the host's baseline immunity or clinical status.
Identified four distinct risk scenarios: Hepatitis B in an unvaccinated host, Varicella in a pregnant and non-immune host, Rabies from a high-risk wildlife bite, and Neisseria meningitidis from close respiratory contact.
Post-exposure prophylaxis guidelines are highly pathogen-specific and depend heavily on host factors like prior vaccination history and pregnancy status.
2
Select the indicated prophylactic modality (active vaccine, passive immune globulin, and/or antimicrobial chemoprophylaxis) for each specific scenario.
Matched Hepatitis B and Rabies with combined vaccine and immunoglobulin regimens; matched Varicella in pregnancy with immunoglobulin alone; and matched Meningococcus with targeted bacterial chemoprophylaxis.
Different pathogens have unique pathogenesis timelines, requiring tailored interventions to successfully abort an active infection.

Key Concept

Post-exposure prophylaxis (PEP) protocols for common infectious diseases
Estimated Time:1m 30s
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Topics

Infectious Diseases

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