Rare Event of Anaphylaxis Reaction in a Rabies Post-Exposure Prophylaxis Vaccine: A Case Report

Abstract

Background. One of the most fatal infectious illnesses, rabies can result in severe symptoms in humans and almost 100% fatality if patients don't receive prompt and sufficient PEP (Post Exposure Prophylaxis). Despite the rarity of allergic responses following rabies immunization, vaccines that protect against infectious illnesses can cause anaphylaxis. Determine if the patient will respond quickly to therapy, pass away in a matter of minutes, or recover on their own as a result of endogenous adrenaline, angiotensin II, and endothelin I secretion. The care of children suffering from anaphylactic shock will be the main topic of this case report. Case Presentation. A six-year-old male patient was admitted to emergency department with shortness of breath, swelling of the whole face and body, gasping for air, and cyanosis of lips, hands, and feet. Previously, the patient was bitten by a dog on the front and right side of his neck 90 minutes prior. He was sent to the community health care facility and administered PEP immediately. It was administered in two ampules without any direct adverse reactions were seen in the following 30-minute observation. Neither previous illnesses nor allergies were reported by his parents. When the patient arrived in emergency room, cyanosis was evident, and he was agitated. Airway was secured using head tilt and chin lift. Oxygen saturation was 60%, thus was given 10 liters/minutes oxygen. He was then given an intramuscular injection of 1:1000 0.3 mg epinephrine and fluid challenge of 300 cc ringer’s lactate solution. Upon reassessing, his vitals sign was not getting better. He had cardiac arrest, resuscitated, but to no avail. Conclusion. During the treatment of rabies, anaphylaxis reactions were inevitable. Post procedure monitoring and emergency management of anaphylaxis reactions must always be prepared to prevent a fatal adverse reaction. Adequate preparation for both equipment and medical personnel is necessary to produce a better outcome. Keywords: Anaphylaxis, Rabies, Post-Exposure Prophylaxis, Vaccine, Children, Case Report