Failure of Postexposure Prophylaxis in A Patient Given Rabies Vaccine Intramuscularly in the Gluteus Muscle, Himachal Pradesh, India

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Vivek Sharma
2. Omesh Kumar Bharti
ISSN
0972-5229
DOI
10.4103/ijccm.IJCCM_521_17
Volume
22
Issue
3
Publishing Year
2018
Pages
2
Author Affiliations
    1. Department of Prosthodontics, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
    1. State Intradermal Antirabies Clinic and Research Centre, DDU Hospital, Shimla, India
  • Article keywords
    Gluteus muscle, postexposure prophylaxis, rabies

    Abstract

    A 48–year-old male was bitten by a dog on the forehead and on the RIGHT side of left eyebrow on November 26, 2017, at 2 pm. The patient was immediately rushed to a nearby private hospital where an MBBS doctor gave him immediate wound wash with soap and water and prescribed five doses of rabies vaccine intramuscularly (IM). Since the patient weight was 60 kg, he was also prescribed 2400 IU of equine rabies immunoglobulin (ERIG), but as eRIG was not available, it was not administered. All the four doses of rabies vaccine were given IM in gluteus muscle. On December 17, 2017, the patient was brought to the Government Regional Hospital Hamirpur with the symptoms of difficulty in swallowing water (Hydrophobia) for 2 days. He was given injection diazepam and referred to Rajinder Prasad Government Medical College Tanda, Kangra, Himachal Pradesh, India, where he died of suspected rabies on December 19, 2017. The explicit consent to publish this report and picture was taken from the relatives of the patient, so that others have a lesson from this case report.

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