Match each clinical exposure scenario with the most appropriate post-exposure prophylaxis strategy for an unimmunized or underimmunized patient.
- Unvaccinated healthcare worker with a needlestick injury from a patient positive for hepatitis B surface antigen.Administer hepatitis B immune globulin and initiate the hepatitis B vaccine series.
- Patient with an unknown immunization history presenting with a deep, soil-contaminated puncture wound.Administer a tetanus toxoid-containing vaccine and tetanus immune globulin.
- Healthy, unvaccinated individual who awakens to find a bat in their bedroom, with no obvious bite marks.Administer rabies immune globulin and initiate the rabies vaccine series.
- Unvaccinated pregnant woman at 18 weeks gestation with a direct, prolonged exposure to a child with active chickenpox.Administer varicella-zoster immune globulin only; live active vaccination is contraindicated.
Cevap
Hepatitis B exposure requires HBIG and the HBV vaccine; severe dirty wounds with unknown history require TIG and Tdap/Td; indoor bat exposures require RIG and the Rabies vaccine; and Varicella exposure during pregnancy requires VZIG only.
Each correct pairing reflects the standard Centers for Disease Control and Prevention (CDC) guidelines for post-exposure prophylaxis in unimmunized patients. For significant exposures to Hepatitis B, Rabies, and Tetanus (via dirty wounds), the standard of care requires providing immediate passive immunity via disease-specific immune globulin, simultaneously paired with the initiation of the active vaccine series for long-term protection. For varicella exposure in a susceptible pregnant woman, only passive immunity is provided because the active vaccine is live-attenuated and strictly contraindicated during pregnancy.
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Anahtar Kavram
Post-Exposure Prophylaxis (PEP) protocols for unimmunized individuals and special populations
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