A patient can be managed after a potential rabies exposure by following a clinical treatment algorithm.
To Treat or Not
(1) Was the patient exposed to one of the following?
(1a) bite or scratch by a mammal
(1b) contamination of open wound or mucous membrane by mammalian saliva
(1c) contamination of open wound or mucous membrane by central nervous system tissue
(2) Is there risk of rabies in species and geographic area where exposure occurred?
(3) Is the source animal a dog or cat in the United States?
(4) Can the dog or cat be observed for rabies?
(5) If the dog or cat can be observed, did the animal sicken and die with signs of rabies within 10 days of exposure?
|
1 |
2 |
3 |
4 |
5 |
Recommendation |
|
N |
|
|
|
|
do not treat |
|
Y |
N |
|
|
|
do not treat |
|
Y |
Y |
N |
|
|
begin treatment |
|
Y |
Y |
Y |
N |
|
begin treatment |
|
Y |
Y |
Y |
Y |
N |
do not treat |
|
Y |
Y |
Y |
Y |
Y |
begin treatment |
If Treatment Begun
(6) Can the animal's brain be examined for rabies?
(7) Is the direct fluorescent antibody test of the animal's brain negative for rabies?
|
6 |
7 |
Recommendation |
|
N |
|
finish treatment |
|
Y |
N |
finish treatment |
|
Y |
Y |
stop treatment |
Specialty: Infectious Diseases, Pharmacology, clinical
