Human Rabies After Antiserum and Vaccine Postexposure Treatment

Publisher Website
Google Scholar
Abstract
An 8-year-old boy was bitten by a rabid dog on the face and treated within 19 hr. with 2,000 IU of antirabies serum injected in the wound and buttocks plus fourteen doses of duck embryo antirabies vaccine with boosters at 10 and 20 days after the series. In spite of this therapy, the patient died of rabies 90 days after exposure. Eighteen sero-vaccine treatment failures were reviewed from the literature. This case report differs from the other failures in the following: he was the youngest patient in the group and the only one in whom an adequate amount of serum was given, part of it being infiltrated locally at the wound sites; he was the only one to receive boosters. In addition, this case represents the shortest interval between the bite (19 hr.) and treatment with serum. Using Hildreth''s criteria this case represents a death following adequate serum vaccine treatment. The most likely explanations for this failure are that serum might not have been given soon enough to work locally and that serum antibody and vaccine antigen interference occurred. Serum plus vaccine represents the best type of post-exposure treatment for rabies available. Perhaps by giving a prolonged series of vaccine (ie, 21 days instead of 14 for serious bites plus boosters which are spaced out for a longer time interval after the basic series, might reduce the number of failures.

This publication has 6 references indexed in Scilit: