doyoudig
Forum Guru
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22 yr old black female provoked her neighbours dog while it was eating food and the dog has bitten on her right arm. dog is not immunised against rabies and doesnot show any signs of rabies. right forearm deep bite wound. wound is cleanes with soap water and povidone iodine. most approp next step in management?
a)kill dog and do brain biopsy
b)abserve dog for 10 days
c)active immunization
d)passive immunization
e)active and passive immunisation
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| Kamsi
Forum Guru
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B
Provoked dog bite,observe for 10 days for signs of rabies
Unprovoked dog or wild animal bite a potential for rabies.If animal is available kill and examine brain for signs of rabies - negri bodies.Rabies propylaxis is mandatory .( Ig and vaccine)
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| dermatology
Forum Elite
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B .... observe dog for 10 days ....
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| Justice
Forum Fanatic
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B
___________________
Don't live in a town where there are no doctors
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| kochs
Forum Senior
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active and passive immunisation is the correct answer.
Read this link-http://www.who.int/rabies/en/WHO_guide_rabies_pre_post_exp_treat_humans.pdf
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| cirus
Forum Guru
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B
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| kpmle2
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b) observe dog for 10 days
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| doyoudig
Forum Guru
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even though it was provoked and here dog does not have rabbies vaccine
should we not give the pts at least passive immunization??? If not why??
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| doyoudig
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to koch they clearly state that the dog is not rapid so vaccine is not given at this stage
but my doubt still lies w/ the fact that dog has no Hx of rabies vaccine, should we give passive and why or why not???????????
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| kochs
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To doyoudig and others,
Irrespective of provoked or unprovoked ,or rabies signs in the suspected dog( its possible that he dog is in incubation period for rabies or may show signs after 10 days ), BITE by an UNVACCINATED dog in this case should be considered an emergency and both active and passive imm..be given.
My opinion is based on the WHO link I have given. Please go through it and give me your opinion.
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| gr8doc
Forum Senior
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I didn't find anywhere in the provided link anything pertaining to the Unvaccinated PET dogs, However, I think giving both active and passive immunisation would make more sense considering the Disease is 100% fatal.
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| cirus
Forum Guru
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vaccinated or not home pet:
Observe if didn run away, if any signs of rabies, then IVIGs & vaccine..
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| elitoki
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The animals without risk of rabie usually don't attack to the person. This case the patient had been bite by provacating the dog, that is normal reaction of the animal. Being domestic animal has low risk for rabie, so we just need to observe the dog.
If this dog bite the person without reason, I think we should give IVIG and vaccine.
Answer is B 
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| doyoudig
Forum Guru
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kochs, I read thru the site and it tell u that if rabies is supected then both should be given, in this case signs of rabies are not present and the bite was provoked so observe the animal if available
if u check most sites they will give a table for proper procedures. And there is a difference in treatments for provoked versus unprovoked dog bites as well as wild animals such as bats, racoons.......
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| doyoudig
Forum Guru
Topics: 144
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in addition this is an 05 UW question and the answer is B as stated for same reasons
I posted this question b/c of the doubt about the dog not being immunized
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| kochs
Forum Senior
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doyoudig, if the healthy pet dog in the question was vaccinated , would go for observation for 10 days. But CDC recommends observation for 10 days in healthy pet dogs as u too say.
Iam yet to subscribe to UW questions.
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| kochs
Forum Senior
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Confused me ! Thanks for the near convincing discussion, doyoudig and others.
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