S13C152 - Rabies

Question 1

Rabies PEP

Answer 1

-clean and debride wound (consider iodine for it virucidality)
-HRIG one dose (w/in 24h)
rabies vaccine 4-5 doses (first w/in 24h then 3,7,14d)

-previously vaccinated:
no HRIG
give one dose of vaccine stat then one 3d later

Question 2

Rabies: clinical course

Answer 2

• incubation 20-90d duration
• prodrome: 2-10d duration, fever, malaise
• acute neuro phase: 2-7d duration, axiety, agitation, depression, hyperventilation, hydrophobia, pharyngeal spasms, confusion, hallucinations, hypoxia, hyperactivity, aerophobia
• come: 0-14d duration: pituitary dyxfxn, cardiac arrhythmia
• death or recovery

Question 3

Rabies Tx:

Answer 3

• steroids are CONTRAINDICATED (worsen outcome)

- no specific tx