Editor’s note: This monthly column serves to challenge pediatricians’ visual diagnosis skills on infectious diseases and provide supporting information on symptoms and treatment.
A 7-month-old infant is brought to your office. Earlier in the day, a bat (similar to the Pipistrellus subflavus shown) was found in the bedroom of the sleeping infant. The bat escaped through an open window. No signs of a bite or scratch are found on physical examination.
Which of the following would be the most appropriate action?
The correct answer is 5, rabies immune globulin plus four doses of rabies vaccine.
Unless rabies can be ruled out by diagnostic testing of the bat, rabies post-exposure prophylaxis (PEP) is recommended. Because bats have small teeth and claws, it is possible to be bitten by a bat and not be aware of the contact or to see...