Examkin

Question

Difficulty: MediumInfectious Diseases

Match each clinical exposure scenario with the most appropriate targeted post-exposure management or prophylaxis protocol.

  • A 28-year-old healthcare worker sustains a deep needlestick injury from a source patient with untreated HIV infection and a high viral load.Initiate a 28-day course of tenofovir-emtricitabine plus raltegravir.
  • A 20-year-old college student shares a small dormitory room with a peer recently hospitalized with confirmed Neisseria meningitidis meningitis.Administer a single oral dose of ciprofloxacin or a short course of oral rifampin.
  • A 35-year-old camper awakens to find a bat in their cabin bedroom. No clear bite marks are identified, and they have no history of prior rabies vaccination.Administer human rabies immune globulin and initiate the rabies vaccine series.
  • A 25-year-old pregnant woman in her first trimester is exposed to a child who subsequently developed the slapped-cheek rash of erythema infectiosum.Perform maternal serologic testing for IgG and IgM antibodies; no targeted antimicrobial prophylaxis is indicated.

Answer

The HIV exposure requires a 28-day 3-drug PEP regimen. The meningococcal exposure requires short-course ciprofloxacin or rifampin. The bat exposure requires rabies immune globulin and vaccine. The Parvovirus B19 exposure requires maternal serology and observation.
Each clinical scenario corresponds to distinct, evidence-based post-exposure management guidelines based on pathogen transmission dynamics and available targeted therapies.

Step-by-Step Solution

1
Identify the recommended post-exposure prophylaxis for occupational HIV exposure.
Tenofovir-emtricitabine plus an integrase inhibitor (raltegravir).
Occupational percutaneous exposure to high viral load HIV necessitates a robust 3-drug antiretroviral regimen to prevent seroconversion.
2
Identify the recommended chemoprophylaxis for meningococcal exposure.
Ciprofloxacin or rifampin.
Living in the same dormitory room constitutes prolonged close contact with respiratory secretions, warranting eradication therapy.
3
Identify the appropriate management for potential rabies exposure.
Rabies immune globulin and vaccine series.
Bat bites can be microscopic. Sleeping in a room with a bat is an absolute indication for full PEP when the animal is unavailable for testing.
4
Identify the appropriate management for Parvovirus B19 exposure in pregnancy.
Maternal serologic testing.
No targeted antimicrobial prophylaxis exists for this virus, so management relies on determining maternal immunity or risk of acute infection.

Key Concept

Targeted Post-Exposure Prophylaxis (PEP) protocols for high-risk infectious exposures
Rate this question

Topics

Infectious Diseases

More questions from this topic